自制皮下引流管联合持续负压吸引预防肥胖患者腹部术后切口脂肪液化的疗效观察

龙生++++++彭艺

[摘要] 目的 探讨自制皮下引流管联合持续负压吸引预防肥胖患者腹部术后切口脂肪液化的疗效。 方法 将本院2011年8月～2013年8月收治的60例肥胖腹部手术患者随机分为观察组和对照组，每组各30例，观察组患者采用自制皮下引流管联合持续负压吸引治疗，对照组患者采用传统碘仿纱布换药治疗，比较两组患者的临床效果。 结果 观察组患者的换药次数低于对照组，异物感发生率高于对照组，两组间差异有统计学意义（P<0.05）；观察组患者的脂肪液化发生率、切口感染发生率及切口裂开发生率与对照组差异无统计学意义（P>0.05）。观察组患者切口甲级愈合率为93.3%，明显高于对照组的83.3%；住院时间明显短于对照组，差异有统计学意义（P<0.05）。 结论 自制皮下引流管联合持续负压吸引预防肥胖患者腹部术后切口脂肪液化的临床效果显著。

[关键词] 引流管；持续负压吸引；肥胖；脂肪液化

[中图分类号] R619[文献标识码] B[文章编号] 1674-4721（2014）06（a）-0173-03

Clinical observation on homemade subcutaneous drainage tube joint continuous negative pressure suction prevention fat liquefaction of abdominal incision in postoperative obese patients

LONG Sheng PENG Yi

Department of General Sugery,People′s Hospital of Xinyi City in Guangdong Province,Xinyi 525300,China

[Abstract] Objective To explore the effect of homemade subcutaneous drainage tube joint continuous negative pressure suction prevention fat liquefaction of abdominal incision in postoperative obese patients. Methods 60 obese patients with abdominal surgery were treated in our hospital from August 2011 to August 2013,they were randomly divided into observation group and control group,each group of 30 cases,the observation group was given homemade subcutaneous drainage tube joint continuous negative pressure suction treated,the control group was given traditional iodoform gauze bandage therapy,the clinical effect of two groups were compared. Results The switching frequency in observation group was lower than that of the control group,the incidence of foreign body sensation was higher than that of the control group,the difference was statistically significant (P<0.05).The incidence of fat liquefaction,infection of incision,increase of the incidence and the incidence of incision dehiscence in observation group compared with the control group,there was no statistically significant difference (P>0.05).The incision class-a healing rate in observation group was 93.3%,significantly higher than the control group of 83.3%.Hospitalization time significantly shorter than that of the control group,the difference was statistically significant (P<0.05). Conclusion The homemade subcutaneous drainage tube joint continuous negative pressure suction prevention fat liquefaction of abdominal incision in postoperative obese patients with clinical effect is remarkable.

[Key words] Drainage tube;Continuous negative pressure suction;Obesity;Fat liquefaction

脂肪液化是手术伤口愈合不良的主要原因之一[1]，一旦出现脂肪液化应及时进行处理，否则易引起切口感染，给患者的预后带来严重影响。有学者认为，腹部手术后切口脂肪液化可能与肥胖、感染、电刀的使用有关[2-3]，目前有研究显示[4-5]，皮下引流管联合持续负压吸引可以有效预防肥胖患者腹部术后切口脂肪液化的发生，本研究主要回顾性分析本院2011年8月～2013年8月收治的60例肥胖患者腹部手术患者的临床资料，以探讨自制皮下引流管联合持续负压吸引预防肥胖患者腹部术后切口脂肪液化的临床效果。

1 资料与方法

1.1 一般资料

所选研究对象为本院收治的60例肥胖患者腹部手术患者，其中男性31例，女性29例；年龄24～78岁，平均（60.5±3.8）岁；手术类型：胆管结石20例、阑尾切除术16例，急性胰腺炎行剖腹探查术8例，胃癌手术11例，嵌顿性腹股沟斜疝手术5例。……