皮下引流联合大黄、芒硝预防妇科手术切口脂肪液化的疗效观察

Clinical Observation of Subcutaneous Transudation Combine with Rhubarb and Mirabilite in Preventing Fat Liquefaction at the Incision after the Gynecological Operation

目的:观察皮下引流联合大黄、芒硝对妇科腹部手术切口脂肪液化的预防作用。方法:选取伴有术后切口愈合不良高危因素的妇科腹部手术60例患者,随机分为观察组和对照组各30例,观察组术中放置多侧孔硅胶负压引流管,术后三天开始用大黄:芒硝=1:4研粉外敷切口,对照组术后三天开始用大黄:芒硝=1:4研粉外敷切口,观察两组患者切口愈合情况。结果:观察组腹部切口常规时间拆线,均Ⅱ/甲愈合。对照组6例出现切口脂肪液化,敞开引流、换药,延期愈合4例,二期缝合2例,观察组切口脂肪液化率明显低于对照组,两者相比差异有显著性(P<0.05),观察组切口平均愈合时间短于对照组,两者相比差异有显著性(P<0.05)。结论:皮下引流联合大黄、芒硝比单用大黄、芒硝更能有效防止妇科腹部手术后切口脂肪液化、促进术后切口愈合。

Objective： To observe the prevention and treatment of incision fat liquefaction after gynecological abdominal surgery incision with external subcutaneous drainage combined with rhubarb and mirabilite application. Methods： Selected 60 patients of gynecological abdominal surgery who had high risk factors of postoperative wound healing and divided them into two groups, the treatment group and the control group, each group had 30 cases.the treatment group given silicone negative pressure drainage tube with multiple side holes in the operation, applicated external rhubarb and mirabilite（1：4）after 3 days. The control group only applicated external rhubarb and mirahilite（1：4）after 3 days. Observation of two groups of patients with wound healing. Results： In the treatment group, all the incisions healed well.In the treatment group, 6 case were fat liquefaction.The fat liquefaction rate of the observation group was lower than that of the control group, there was a significant difference between the two groups（P〈0.05）; The healing time of the observation group was shorter than that of the control group, there was a significant difference between the two groups（P〈0.05）. Conclusion： Subcutaneous drainage combined with rhubarb and mirabilite external application can promote incision cure after abdominal operation and reduce incision fat liquefaction.