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目的探讨前次手术腹部横切口对再次经腹手术的影响。方法2005年2月至2007年12月收治需二次手术患者102例。纵切口48例,横切口54例,两组均沿原手术疤痕行纵、横切口,逐层切开腹壁各层,打开腹腔,观察前次手术盆腹腔粘连情况,测算开腹时间、手术总时间、开腹出血量及术中总出血量。结果前次手术有43.75%～44.45%腹部切口下方与大网膜、肠管、子宫、膀胱粘连(纵切口为43.75%,横切口为44.45%),两组比较,差异无统计学意义(P>0.05);纵切口行二次手术时再开腹时间、手术时间、开腹出血量及术中总出血量均少于横切口,差异有统计学意义(P<0.05),而无一例副损伤及皮肤感觉障碍。结论对于妇科疾病需开腹手术及剖宫产,以腹部正中纵切口为宜。
Objective To investigate the effect of previous abdominal transverse incision on reoperation. Methods From February 2005 to December 2007, 102 patients undergoing secondary surgery were enrolled. 48 cases of longitudinal incision, transverse incision 54 cases, both groups along the original surgical scar longitudinal and transverse incision, layer-by-layer incision abdominal layers, open the abdominal cavity, observe the previous abdominal adhesions, calculate the time of laparotomy, surgical total Time, abdominal bleeding and total blood loss during surgery. Results The results of the previous operation showed that there was no significant difference between the two groups (43.75% -44.45%), the omentum, the intestine, the uterus and the bladder adhesions (43.75% for longitudinal incision and 44.45% for transverse incision) 0.05). The length of reoperation, operation time, open abdominal bleeding and total intraoperative blood loss were less than that of transverse incision in longitudinal incision. The difference was statistically significant (P <0.05) And skin sensation. Conclusions For gynecological diseases, laparotomy and cesarean section are required, and the longitudinal incision in the middle of the abdomen should be appropriate.