肝硬化门静脉高压症患者切口延迟愈合分析

Retrospective analysis on delayed healing of abdominal postoperative incision in patients with portal hypertension

目的探讨肝硬化门静脉高压症患者术后切口延迟愈合的危险因素。方法采用回顾性调查的方法,分析228例肝炎后肝硬化门静脉高压症患者接受断流术的临床资料,切口延迟愈合病例为观察组(95例),切口愈合良好病例为对照组(133例),筛选分析与术后切口延迟愈合相关的影响因素。结果观察组共95例,切口延迟愈合发生率41.67%。观察组中切口感染29例(1.27%);切口脂肪液化60例(26.32%);切口裂开6例(2.63%)。观察组的急诊手术比例、术前住院时间、皮下脂肪厚度、肝功能Child-Pugh分级、脾脏功能亢进程度、手术时间、术中出血量、开腹使用电刀功率等与对照组比较,差异均有统计学意义(P均<0.05)。结论肝硬化门静脉高压症患者切口延迟愈合,除与皮下脂肪厚度、电刀的使用、手术持续时间等因素相关外,患者围手术期肝功能状态及脾功能亢进程度对于术后切口愈合亦有显著影响。

Objective To analyze the risk factors of delayed healing of abdominal postoperative incision in patients with portal hypertension. Methods Clinical data of 228 cases of posthepatitic cirrhosis with portal hypertension were analyzed retrospectively. Cases of delated healing of incision were taken as observation group （95 cases） and incision healed well cases as control group （133 cases）. The influencing factors of postoperative delayed healing of incision were screened and analyzed. Results Incidence rate of delated healing of incision was 41.67%. In observation group, the infection of incisional wound occured on 29 cases （1.27%）, the fat liquefaction of incision on 60 cases （26.32%）, the disruption of wound on 6 cases （2.63%）. The influencing factor included with or without emergency operation, fat thickness, Child-Pugh classification, hyperfunction degrees of the spleen, operation time, volume of blood loss and power of the electrotome between two groups were statistically significant （P all〈0.05）. Conclusions In addition to subcutaneous fat thickness, power of the electrotome, operation time, delayed healing of abdominal postoperative incision in patients with portal hapertension is also inlfuenced by the liver function status and splenic function of perioperative patients.