预防性减张缝合对影响高龄患者腹部切口愈合质量的临床研究

The Effect of Prophylactic Tension Suture on Abdominal Wound Healing in Elderly Patients

目的研究预防性减张缝合技术(PTS)对影响高龄患者腹部切口愈合质量的临床效果。方法总计100例60岁以上不同程度低蛋白血症的高龄患者,合并慢性支气管炎肺气肿、糖尿病、心血管疾病、腹水。采用前瞻性随机对照方法,分为预防性减张缝合组(PTS组)及对照组(按标准方法缝合腹壁,nonPTS组)。收集的数据包括切开裂口、切口感染、切口脂肪液化、切口疝、皮下积血、局部皮肤坏死。结果PTS组与nonPTS组中切口裂开、切口疝、切口感染、切口脂肪液化、皮下积血的发生情况有显著性差异(P<0.05),而在局部皮肤坏死并发症上有非常显著性差异(P<0.01)。结论应用PTS对预防高龄患者腹部切口裂开、切口疝是非常有效的,且提高了切口愈合质量,但应注重缝合技巧。

Objective To study the clinical effect of prophylactic tension suture （PTS） on abdominal wound healing in elderly patients. Methods One hundred hypoproteinemic patients more than 60 years of age with chronic obstructive pulmonary disease, diabetes mellitus, cardiovascular disease or ascites were randomly assigned into PTS group and non-PTS （continuous absorbable suture） group. The incision dehiscence, incision infection, incision fat liquefaction, incision hernia, subcutaneous congestion/hematoma, and local dermonecrosis were statistically tested. Results The incidence of incision dehiscence, incisional hernia, incision infection, incision fat liquefaction, and subcutaneous congestion/hematoma in the two groups was significantly different （P〈0.05）. And there was very significant difference in the incidence of dermonecrosis （P〈0.01）. Conclusion PTS is an effective method in prevention of abdominal incision dehiscence and hernia in elderly patients. And the quality of wound healing was promoted by PTS. But emphasis should be laid on the suture skill while utilizing this technique.