腹部切口放置皮下负压引流管在肥胖胃十二指肠穿孔患者手术中的应用

Application of Subcutaneous Negative Pressure Drainage Tube in the Operation of Obese Patients with Duodenal Perforation

目的:探讨切口腹白线前放置皮下硅胶负压引流管在肥胖胃十二指肠穿孔患者手术中的应用价值。方法:回顾分析2008年1月-2014年10月行胃十二指肠穿孔修补术的80例肥胖胃十二指肠穿孔患者,随机分为分为对照组(n=40)和试验组(n=40),对照组患者予腹部切口稀释碘伏及生理盐水冲洗干预,试验组患者在对照组常规处理基础上予切口腹白线前放置硅胶管接负压瓶负压引流干预,两组患者年龄、体重指数、切口长度、手术时间、穿孔部位、穿孔时间比较差异无统计学意义(P>0.05),分析两组切口愈合情况、切口感染率、切口脂肪液化率及住院时间等。结果:试验组切口甲级愈合率(90.0%)、切口感染率(2.5%)、脂肪液化率(7.5%)与对照组的47.5%、17.5%、35%比较差异有统计学意义(P<0.05)。两组住院时间比较差异有统计学意义(P<0.05)。结论:切口腹白线前放置硅胶管负压引流能减少肥胖胃十二指肠穿孔患者术后切口感染率,利于切口愈合,减少住院时间,有临床应用价值。

Objective： To discuss the application of subcutaneous negative pressure drainage tube in the operation of obese patients with duodenal perforation.Method： 80 cases of obese patients with gastroduodenal perforation January 2008 to October 2014 underwent gastroduodenal repair perforation were randomly divided into control group（n=40） and experimental group（n=40）, the control group was treated with abdominal incision diluted iodophor and saline intervention, the experimental group was given abdominal incision white line placing silicone tube suction negative pressure drainage bottle intervention on the basis of control group.There was no difference of patients Age, body mass index, incision length, operative time, time of perforation perforation between two groups（P~,0.05）, The wound healing, wound infection rate, incision fat liquefaction rate and hospitalization time of two groups were analyzed.Result： The wound healing rate of experimental group was 90.0%, wound infection rate was 2.5%, fat liquefaction rate was 7.5%, and the control group was 47.5%, 17.5%, 35%, the differences were statistically significant（P〈0.05）.The difference of hospitalization time between two groups was statistically significant（P〈0.05）. Conclusion： The abdominal incision white line placing silicone tube suction negative pressure drainage bottle intervention can reduce the rate of postoperative wound infection in obese patients with gastric and duodenal perforation, which is conducive to wound healing, reduce the length of hospital stay, and has clinical application value.