浓氯化钠合并胰岛素治疗妇科腹部伤口愈合不良的临床研究

目的:研究通过对妇科患者开腹术后伤口愈合不良者运用浓氯化钠注射液合并中性胰岛素进行伤口湿敷换药,观察伤口愈合情况。方法:选取2016年1月至2018年1月住院开腹手术术后伤口愈合不良的80例患者,按换药方式分为浓氯化钠合并胰岛素换药组和双氧水、0.9%的氯化钠溶液合并生物胶换药组,每组40例,比较两组换药后伤口渗液情况,平均换药次数、平均住院时间情况、术后随访半年伤口愈合情况。结果:两组在伤口渗液情况,平均换药次数、平均住院时间指标方面均存在明显差异,P<0.05,差异有统计学意义,术后随访两组伤口均完全愈合,差别不大,P>0.05,无统计学意义。结论:浓氯化钠注射液合并配中性胰岛素进行伤口湿敷换药比传统换药方式能更好地促进伤口愈合,从而缩短住院时间,减少医疗费用。

微波治疗与健康教育促进腹部伤口愈合的疗效观察

目的：比较微波配合健康教育与常规单纯外科换药治疗腹部伤口的疗效。方法：采用MTC-5全新脉冲控制型微波治疗仪配合健康教育与单纯外科常规换药法比较。结果：微波治疗配合健康教育后，伤口愈合快，住院日缩短。结论：微波配合健康教育，在腹部伤口愈合过程中，能起到很好的促进作用。

薇乔线内缝腹部切口50例

腹部伤口愈合美观是每个术后患者特别是年轻妇女手所期望的，当她们接受剖宫产术、卵巢肿瘤切除术，宫外孕手术、子宫肌瘤切除术后，看到暄部留下瘢痕都会感到烦恼。我们采用薇乔线行腹部皮内连缝合50例，取得较满意的效果，现报告如下。

不同会阴缝合方法1286例愈合效果观察

会阴切口缝合是产科常见的缝合之一,会阴伤口愈合美观同腹部伤口愈合美观一样重要[1]。过去我们用肠线加丝线缝合,但是患者住院时间长,切口缝线反应多,后改为铬制肠线皮内缝合,缩短了患者住院时间,但排线反应较多,近年来我们又采用薇乔线替代肠线,效果明显优于前两者。

剖宫产后并发急性肺栓塞抢救成功一例

患者女性，30岁，主因“宫内妊娠39周，孕1产0胎膜早破”于2010年8月18日6：30急诊入院，因胎儿窘迫于2010年8月19日10：00椎管内麻醉下行剖宫产术，手术后给予止血、补液、抗感染治疗。患者一般情况良好，心肺未见异常，腹部伤口愈合良好，

Continuous wound infusion of local anaesthetic agents following colorectal surgery:Systematic review and meta-analysis

AIM:To provide a specifi c review and meta-analysis of the available evidence for continuous wound infusion of local anaesthetic agents following midline laparoto-my for major colorectal surgery. METHODS: Medline, Embase, trial registries, conference proceedings and article reference lists were searched to identify randomised, controlled trials of continuous wound infusion of local anaesthetic agents following colorectal surgery. The primary outcomes were opioid consumption, pain visual analogue scores (VASs), return to bowel function and length of hospital stay. Weighted mean difference were calculated for continuous outcomes. RESULTS: Five trials containing 542 laparotomy wounds were eligible for inclusion. There was a sig- nificant decrease in post-operative pain VAS at rest on day 3 (weighted mean difference: -0.43; 95% CI: -0.81 to -0.04; P = 0.03) but not on post-operative day 1 and 2. Local anaesthetic infusion was associated with a signifi cant reduction in pain VAS on movement on all three post-operative days (day 1 weighted mean difference: -1.14; 95% CI: -2.24 to -0.041; P = 0.04, day 2 weighted mean difference: -0.97, 95% CI: -1.91to -0.029; P = 0.04, day 3 weighted mean difference: -0.61; 95% CI: 1.01 to -0.20; P = 0.0038). Local an- aesthetic wound infusion was associated with a signifi - cant decrease in total opioid consumption (weighted mean difference: -40.13; 95% CI: -76.74 to -3.53; P = 0.03). There was no signifi cant decrease in length of stay (weighted mean difference: -20.87; 95% CI: -46.96 to 5.21; P = 0.12) or return of bowel function (weighted mean difference: -9.40; 95% CI: -33.98 to 15.17; P = 0.45). CONCLUSION: The results of this systematic re- view and meta-analysis suggest that local anaesthetic wound infusion following laparotomy for major color- ectal surgery is a promising technique but do not pro- vide conclusive evidence of benefi t. Further research is required including cost-effectiveness analysis.