改进腹壁切口缝合及引流技术预防阑尾术后切口感染的临床观察

目的探讨减少化脓性、穿孔性、坏疽性阑尾炎手术切口感染的方法。方法化脓性、穿孔性、坏疽性阑尾炎患者507例，随机分成A组（用3-0可吸收线缝合腹膜后，将腹壁的全层用7号丝线间断缝合，并加腹壁负压管引流）205例和B组（常规用丝线缝合腹壁各层加腹膜外置切口负压管引流）302例。观察切口是否红肿痛和脓性分泌物、切口是否裂开、平均住院天数。结果A组切口感染2例（0．98％），平均住院（8．5±1）d；B组：切口感染2l例（6．95％），平均住院（14．9±1）d。A组明显优于对NB组（P〈0．05）。结论全层缝合腹壁切口加腹壁负压管引流是预防阑尾炎切口感染的有效方法，明显缩短平均住院天数。

Objective To explore a way to reduce the suppurative and gangrenous and perforated appendicitis, surgical incision infection. Methods Cases of perforation, suppurative and gangrenous appendicitis in 507 cases of patients were randomly divided into A group （ i.e. with 3-0 absorbable suture of the retroperitoneal, abdominal wall layer with 7 silk suture, and abdominal wall negative pressure drainage ） 205 cases and control group B （ conventional each layer with silk suture of abdominal wall and abdominal wall negative pressure drainage ） 302 cases. Observation of incision is red swelling and purulent secretions, incision is split, the average hospitalization days. Results In group A there were 2 cases of incision infection on average （0.98%） In （8.5 ± 1 ） d; group B： 21 cases of incision infection （6.95%） , the average hospitalization （ 14.9± 1 ） d.A group was significantly better than the control group B （ P〈0.05 ） . Conclusion The suture of abdominal wall incision add abdominal wall with negative pressure drainage is an effective way to prevent incisional infection, to shorten the average hospitalization there are significant days.