横切口腹膜外单层缝合用于妊娠期化脓性阑尾炎治疗

Transverse abdominal incision sutured by single layer extraperitoneal suture for purulent appendicitis during gestational period

目的探讨横切口腹膜外单层缝合法应用于妊娠期化脓性阑尾炎的临床效果。方法 2006年1月至2010年11月3所大学附属医院收治129例妊娠期化脓阑尾炎患者,分为2组,观察组68例采用横切口腹膜外单层缝合法行阑尾切除术,对照组61例常规麦氏切口(或横切口)分层缝合法行阑尾切除术,对2组患者的手术时间、术后疼痛程度、术后流产或早产率、术后切口感染率、术后住院时间等指标进行观察比较。结果观察组与对照组术后流产或早产率比较差别无统计学意义(P>0.05)。观察组可明显减少手术时间(P<0.01),降低患者术后切口疼痛、切口感染率及术后住院时间(P<0.01)。2组患者在住院治疗期间均未发生切口出血、切口疝、肠粘连、肠梗阻等并发症。结论横切口腹膜外单层缝合法在妊娠期化脓性阑尾炎切除术中具有操作简单、安全、并发症少等优点,值得推广。

Objective To investigate the clinical effect of transverse abdominal incision sutured by single layer extraperitoneal suture for purulent appendicitis during gestational period.Methods During January 2006 to November 2010,129 patients with suppurative appendicitis from three universities＇ affiliated hospital were divided into observation group and control group.Sixty-eight patients in observation group were taken transverse incision sutured by single layer extraperitoneal suture after appendectomy.Sixty-one patients in control group were taken McBurneys′ incision（or transverse incision） sutured by multi-layer extraperitoneal suture for the appendectomy.The operating time,the degree of postoperative pain,the abortion or premature birth rate,the incision infection rate and the length of hospitalization of patients between observation group and control group were compared.Results There were no statisitic significance of the abortion or premature birth rate between observatioin group and control group（P0.05）.The operating time,the degree of postoperative pain,the incision infection rate and the length of hospitalization in observation group were significantly shorter than thoes in control group（P0.01）.There were no complications,such as incisional bleeding,incisional hernia,intestinal adhesion and intestinal obstruction were found between two groups.Conclusion The transverse abdominal incision suture by single layer extraperitoneal suture is simple and safe with less complication,which is deserved to be popularized for the patients with suppurative appendicitis during gestational period.