新型腹壁切口缝合术在妇科肥胖型肿瘤患者手术中的应用价值

Application Value of New Type Abdominal Incision Suture in Gynecologic Tumor Surgery of Obese Patients

目的:探讨新型腹壁切口缝合方法在妇科肥胖患者手术中的临床应用价值。方法:收集2010年1月至2014年10月260例妇科肥胖肿瘤患者,将腹壁切口随机分为两组,138例采用新型缝合法(实验组),其中20例无合并糖尿病等基础疾病者不缝合脂肪层;122例采用常规缝合法(对照组)。比较两组间的腹壁缝合时间、合并糖尿病者切口愈合率、切口Ⅰ期愈合率和术后住院天数。结果:两组患者的年龄、手术方式、合并糖尿病例数等差异无显著性(P>0.05);实验组腹壁切口缝合时间、合并糖尿病患者切口愈合率、切口Ⅰ期愈合率、术后住院天数分别(18.50±5.15)min、100%、100%、(5.00±2.35)d,对照组分别为(26.00±4.10)min、53.3%、76.5%、(8.70±2.52)d,两组各项指标差异均有统计学意义(P<0.05)。实验组中20例不缝合脂肪层者,缝合时间进一步缩短,引流效果、切口Ⅰ期愈合率和术后住院天数方面与实验组内其他病例比较没有差异性。结论:新型腹壁切口缝合法具有缝合时间短、Ⅰ期愈合率明显提高、术后住院天数缩短等优势,对合并糖尿病肥胖患者的效果更加显著,是一种操作易行、安全可靠的实用缝合法,具有较高的临床应用价值。

Objective：To explore the application value of new type of incision suture method in obese patients with pelvic tumors.Methods：260cases of gynecological tumors patients with obesity from January 2010 to October 2014 were collected,and surgical incision were randomly divided into two groups,138 cases were treated by using the new type of incision suture method（experimental group）,in which no fat layer suture was conducted in 20 cases who did not have basic diseases such as diabetes mellitus;122cases were treated with conventional suture method（control group）.There was a comparison between the two groups in suture time,stage Ⅰ of incision healing rate and postoperative hospitalization days.Results：There was no significant difference between two groups of patients in age,operation method,and the number of cases with diabetes mellitus（P0.05）.Incision suture time,incision healing rate in patients with diabetes rate,postoperative stageⅠincision healing rate,and the postoperative hospitalization days in experi-mental group were（18.50±5.15）minutes,100%,100%,and（5.00±2.35）days respectively,while（26.00±4.00）minutes,53.3%,76.5%,and（8.70±2.52）day in the control group,respectively.all the Pvalue were less than 0.05,which show the significant differences between two groups.Twenty cases who had no suture fat layer in the experimental group,their suture time was shortened,but compared with other cases in the experimental group there were no differences in drainage effect,phaseⅠ healing rate and postoperative hospital stays.Conclusion：This new suture of abdominal wall incision method for treating with gynecological obese abdominal incision is advantageous in shortening suturing time,improving stage Ⅰ healing rate,and shortening postoperative hospital stays,which is effective in treating obese with diabetes mellitus,it is an easy,safe and reliable suture of high clinical value.