目的 探讨自制简易负压引流装置在预防剖宫产腹部切口脂肪液化中的应用价值.方法 选取在妇产科住院的246例具有脂肪液化高危因素的剖宫产产妇作为观察组,关腹时在筋膜浅面及皮下脂肪深面间置输血器管作为引流管,以20 mL塑料注射器持续负压引流.选取同期手术的具有同样高危因素的剖宫产产妇272例为对照组,手术切口常规缝合.观察两组切口脂肪液化及愈合情况.结果 对照组脂肪液化发生率高于观察组(P<0.05),切口愈合时间及住院时间长于观察组(P<0.05);观察组中横、纵切口间脂肪液化率差异无统计学意义,对照组中纵切口的脂肪液化率明显高于横切口(P<0.05);不同高危因素两组间脂肪液化情况比较,在高危因素肥胖、皮下脂肪过厚、低蛋白血症、糖尿病、中重度贫血、同时存在两项高危因素以上中,对照组的脂肪液化率均明显高于观察组(P<0.05),在高危因素下腹部手术史和妊娠高血压疾病中,两组脂肪液化率比较差异无统计学意义.结论 自制简易负压引流装置对预防剖宫产腹部切口脂肪液化具有明显作用.该装置制作简单、便于携带、成本低,易于各级医院推广应用.%Objective To evaluate the application of negative pressure drainage device in the prevention of fat liquefaction oi abdominal incision following cesarean section . Methods 246 pregnant women with high risk factors for fat liquefaction of abdominal incision were selected as treatment group . A transfusion apparatus tube was inserted between the anterior rectus sheath and subcutaneous fat as a suction drain at incision closure , as the continuous negative pressure was kept by a 20 mL syringe. Another 272 patients with the same high risk factors were enrolled in control group simultaneous -ly, received a conventional incision closure without the drain . The incidence of fat liquefaction and healing time of abdom -inal incision were observed. Results Significantly higher incidence of fat liquefaction , and longer healing time of abdomi -nal incision and hospital stay were observed in control group ( P < 0. 05 ). There was no significant difference in the inci -dence of fat liquefaction between longitudinal incision and transverse incision in treatment group ; while longitudinal inci -sion complicated with significantly higher incidence of fat liquefaction in control group ( P < 0. 05 ). The risk factors of fat liquefaction included obesity , thick subcutaneous fat, diabetes, hypoproteinemia, moderate or severe anaemia , abdominal surgery history and hypertensive disorders in pregnancy . However, there was no significant difference in incidence of fat liquefaction in patients with abdominal surgery history or hypertensive disorders in pregnancy between the two groups . Conclusion The new negative pressure drainage device is effective in preventing fat liquefaction of abdominal incision af -ter cesarean section.
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