论文部分内容阅读
目的探讨剖宫产腹部切口脂肪液化的原因及防治措施。方法对47例剖宫产术后腹部切口脂肪液化的临床资料做回顾性分析。结果剖宫腹产术后切口脂肪液化率0.9%(47/5 021),主要原因是合并肥胖、糖尿病、妊娠水肿、贫血和产程停滞、术中使用电刀及术后咳嗽等。根据伤口渗出液量的多少将患者分两组:A组渗出液少;B组渗出液多。两组均采用局部挤压脂肪液,或拆开部分切口缝线引流、清除坏死组织等治疗,经局部处理后覆盖大片苯扎氯铵贴等措施,直至切口干燥无渗液。治疗结果:B组患者于剖宫产术后(8.2±1.2)d出院,切口愈合(13.4±2.6)d;A组分别仅需(5.8±0.8)d和(10.5±1.7)d。两组切口均无感染,愈合情况好,无需二期缝合,亦未发生医疗纠纷。结论 B组病人因渗出液多,所需的住院天数与切口愈合天数均较长。应重视腹部切口脂肪液化发生的各种高危因素,早期发现并积极处理会缩短切口愈合时间,明显缩短住院时间,避免发生医疗纠纷。
Objective To investigate the causes and prevention measures of fat liquefaction in abdominal incision of cesarean section. Methods The clinical data of 47 cases of celiac fat incision after cesarean section were analyzed retrospectively. Results Cesarean section incision fat liquefaction rate of 0.9% (47/5 021), the main reason is the combination of obesity, diabetes, edema of pregnancy, anemia and labor stagnation, intraoperative use of electric knife and postoperative cough. According to the amount of wound exudate patients will be divided into two groups: A group exudate less; B group exudate. Two groups were used local squeeze fat solution, or open part of the incision suture drainage, removal of necrotic tissue and other treatment, after local treatment covered with large pieces of benzalkonium chloride paste and other measures until the incision dry without effusion. Results: The patients in group B were discharged at 8.2 ± 1.2 d after cesarean section and the incision healed (13.4 ± 2.6) days. The patients in group B were only 5.8 ± 0.8 d and 10.5 ± 1.7 d respectively. No incision infection in both groups, healing good, no two suture, nor medical disputes. Conclusion Patients in group B had longer exudation days and longer hospitalization days due to more exudate. Should pay attention to abdominal incision fat liquefaction of various risk factors, early detection and active treatment will shorten the incision healing time, significantly reduce hospital stay, to avoid medical disputes.