腹部正中经脐切口与绕脐切口的对照研究

Transumbilical versus circumumbilical abdominal incision: a case control study

  • 摘要: 目的:比较腹部正中绕脐切口与腹部正中经脐切口在腹部手术中的临床作用。
    方法:回顾性分析2011年 5月至2013年4月首都医科大学附属北京天坛医院收治的71例行开腹手术患者的临床资料,其中41例腹部正中经脐切口患者设为经脐组,30例正中绕脐切口患者设为绕脐组。分析两组患者术中情况和切口相关并发症情况。术后采用复查随访,随访时间截至2013年12月。正态分布的计量资料数据以±s表示,采用t检验;计数资料比较采用χ2或Fisher确切概率法检验。
    结果:经脐组患者切口类型Ⅱ类和Ⅲ类分别为38例和3例,与绕脐组患者的28例和2例比较,差异无统计学意义(P>0.05);两组患者手术时间分别为(186±43)min和(196±55)min,术中出血量分别为(255±152)mL和(326±172)mL,两组比较,差异均无统计学意义(t=-0.807,-1.799,P>0.05)。经脐组患者腹部切口长度为(14.3± 4.3)cm,绕脐组为(17.3±2.9)cm,两组比较,差异有统计学意义(t=-3.288,P<0.05)。术后切口并发症发生率分别为4/41和6/30,两组比较,差异无统计学意义(P>0.05)。术后住院时间分别为(23±12)d和(26±14)d,两组比较,差异无统计学意义(t=-0.933,P>0.05)。71例患者获得随访,随访时间为8~26个月,中位随访时间为15个月,两组患者术后脐部及周围皮肤愈合良好,经脐组患者腹部切口呈直线,未见其他特殊并发症发生。
    结论:腹部正中经脐切口长度短于腹部正中绕脐切口,且未增加切口相关并发症的发生,切口愈合美观。

     

    Abstract: Objective:To compare the clinical efficacy of transumbilical and circumumbilical abdominal incision in the abdominal surgery. Methods:The clinical data of 71 patients who underwent open surgery at the Beijing Tiantan Hospital from May 2011 to April 2013 were retrospectively analyzed. All the patients were divided into the transumbilical group (n=41) and circumumbilical group (n=30) according to the selection of incisions. The intraoperative conditions of patients and incisionrelated complications between the 2 groups were analyzed. Patients were followed up by outpatient examination and reexamination till December 2013. The measurement data with normal distribution were presented as ±s and analyzed using t test, and the count data were analyzed using the chisquare test or Fisher exact probability.
    Results:The type Ⅱ and type Ⅲ incisions were used in 38 and 3 patients in the transumbilical group and 28 and 2 patients in the circumumbilical group, respectively, showing no significant difference between the 2 groups (P>0.05). The operation time and volume of intraoperative blood loss in the transumbilical group and in the circumumbilical group were (186±43)minutes, (255±152)mL and (196±55)minutes, (326±172)mL, respectively, with no significant difference between the 2 groups (t=-0.807,-1.799, P>0.05). The length of incision in the transumbilical group was (14.3±4.3)cm, which was significantly different from (17.3±2.9)cm in the circumumbilical group (t=-3.288, P<0.05).The incidence of incisionrelated complications and duration of hospital stay were 4/41 and (23±12)days in the transumbilical group and 6/30 and (26±14)days in the circumumbilical group, respectively, with no significant difference between the two groups (t=-0.933, P>0.05). All the 71 patients were followed up for 8-26 months, with a median time of 15 months. The surgical wounds between the 2 groups healed well. The abdominal incisions in the transumbilical group were in a straightline shape, without occurrence of other complications.
    Conclusion:Transumbilical incision compared with circumumbilical incision in abdominal operations has a shorter length, without increasing incisionrelated complications and with cosmetic benefits.

     

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