摘要
目的:探讨停留皮下引流管在预防肥胖患者行急诊剖腹探查术后切口感染的价值。方法:回顾性分析2021年7月至2023年6月期间广东省中山市人民医院普外三科和西藏自治区工布江达县人民医院外科收治的140例行急诊剖腹探查术肥胖患者，根据术中有无放置切口皮下引流管分为引流管组和对照组，观察并分析两组患者术后切口愈合情况、围手术期及随访情况等资料。结果:两组患者在基线临床资料方面比较差异无统计学意义，引流管组在切口一期愈合率（χ2=5.221，P=0.035）、14 d切口愈合率（χ2=5.082，P=0.032）、切口愈合时间（t=2.917，P=0.040）、拆线时间（t=3.279，P<0.001）优于对照组，而在切口脂肪液化/渗液（χ2=12.443，P<0.001）、切口感染率（χ2=5.347，P=0.025）、二次缝合率（χ2=4.674，P=0.036）均低于对照组，且提高了患者的住院满意度（t=5.221，P=0.045），差异均有统计学意义。结论:在肥胖患者急诊剖腹探查术切口停留皮下引流管可有效预防切口感染，值得临床推广应用。
Abstract
Objective:To explore the value of subcutaneous drainage tube in the prevention of incisional infection after emergency laparotomy in obese patients.Methods:140 obese patients undergoing emergency laparotomy from July 2021 to June 2023 in the Third Department of General Surgery of the People’s Hospital of Zhongshan City and Department of Surgery, the People’s Hospital of Gongbo’gyamda County, Xizang Autonomous Region were divided into the drainage tube group and the control group by whether staying a subcutaneous drainage tube or not in the surgery. The following data were observed and retrospectively analyzed of the incision recovery condition, the perioperative and follow-up clinical data.Results:There were no significant differences in baseline clinical data between the two groups. The drainage tube group was superior to the control group in terms of primary incisional healing rate (χ2=5.221, P=0.035), 14 days incisional healing rate (χ2=5.082, P=0.032), incisional healing time (t=2.917, P=0.040) and suture removal time (t=3.279, P<0.001). While in terms of incisional fat liquefaction/seepage (χ2=12.443, P<0.001), incisional infection rate (χ2=5.347, P=0.025) and secondary suture rate (χ2=4.674, P=0.036), it was lower than the control group, and the patients’hospitalization satisfaction was improved (t=5.221, P=0.045). The differences between the two groups were statistically significant.Conclusion:The subcutaneous drainage tube can effectively prevent the incisional infection after emergency laparotomy in obese patients, which is worthy of clinical promotion and application.
万方数据