前鞘下负压引流装置用于预防二次剖宫产术后腹壁血肿的研究

A Study of the Application of Anterior Sheath Negative Pressure Drainage Device in Prevention of Abdominal Wall Hematoma after Repeated Caesarean Section Operation

目的探讨前鞘下负压引流装置对二次剖宫产术后腹壁血肿发生率的影响。方法选取2006-2014年在重庆市东南医院行二次剖宫产术产妇400例,根据手术方式分为观察组和对照组,各200例,所有患者均采用Pfannenstiel切口式剖宫产,但对观察组的手术方式做了进一步改进。比较2组患者剖宫产术后腹壁血肿发生情况及切口愈合情况。结果观察组腹壁切口甲级愈合率、腹壁各层组织血肿发生率、皮下脂肪液化发生率分别为98.50%,16.50%,1.00%;对照组为94.00%,56.50%,5.00%,观察组患者腹壁各层组织血肿发生率明显低于对照组,差异有统计学意义(P<0.01)。结论前鞘下负压引流装置能有效防止二次剖宫产术后发生腹壁各层组织血肿及皮下脂肪液化,从而降低二次盆腔手术的风险,减轻患者的痛苦。

Objective To discuss the effect of anterior sheath negative pressure drainage device on the occurrence rate of abdominal wall hematoma after repeated caesarean section operation. Method To select 400 cases of maternity patients who have undergone repeated caesarean section operation at Chongqing Dongnan Hospital from 2006 to 2014, and divide them according to the operation methods into the observation group and the comparison group with each having 200 patients. All of them received the Pfannenstiel incision style caesarean section, while the operation method on the patients of the observation group was further improved, and to compare the state of the occurrence of abdominal wall hematoma after caesarean section operation and the heal- ing of the incision of the patients of the two groups. Results The first class healing rate of abdominal wall incision, the hematoma occurrence rates of different layers of abdominal wall, the occurrence rate of subcutaneous fat liquefaction of the observation group were 98.50%, 16.50%, and 1.00% respectively, while the same indicators of the comparison groups were 94.00%, 56.50%, and 5.00% respectively, the hematoma occurrence rates of different layers of abdominal wall of the former being markedly lower than those of the latter, and the differences were statistically significant （P〈0.01）. Conclusion The anterior sheath negative pressure drainage device can effectively prevent hematoma of different layers of abdominal wall and the subcutaneous fat liquefaction after repeated caesarean section operation, hence reduce the risks of repeated pelvic operation, and lessen the pains of patients.