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改良筋膜横切口保留腹壁浅静脉的临床意义 |
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刘涛 戴淑真 魏敏
【摘要】 目的 探讨改良筋膜横切口保留腹壁浅静脉的临床意义。方法 对42例剖宫产患者采用改良筋膜横切口，术中保留一侧腹壁浅静脉，而对侧静脉横断，进行同体对照比较，术后3天用远红外线计算机化热成像（CET）仪对切口进行测温分析，术后40天用游标卡尺对瘢痕厚度进行测量分析。结果 （1）切断血管侧温度为(36.7±0.51)℃；保留血管侧为(35.8±0.81)℃。切口双侧术后温度差为（0.098±0.088）℃，两者比较，差异有极显著性（P<0.01）。切断血管处局部在CET显示屏上呈相对热区改变。（2）术后40天测切口双侧瘢痕厚度，切断血管侧为(3.61±0.61)mm，保管血管侧为(3.10±0.68)mm，两者差为（0.546±0.1）mm，两者比较，差异有极显著性（P<0.01）。结论 改良筋膜横切口保留腹壁浅层血管可有效地减轻局部炎性反应，并减轻瘢痕形成。
【关键词】 剖宫产术 炎症 瘢痕 方法
The Clinical Significance of Preserving Superior Epigastric Vessels in Cohen Incision
LIU Tao, DAI Shuzhen, WEI Min.
Qingdao Municipal Hospital， Qingdao 266071
【Abstract】 Objective To study the clinical significance of preserving epigastric vessels in Cohen incision. Methods 42 cases of pregnant women were performed cesarean section using Cohen incision. One side vessel of incision was preserved, the other side was cut off. By self control comparison, skin temperature of two sides incision has been taken by CET (computer electric infrared thermograph) on the third day post operation. The thinkness of scar was measured with vernier calipers on the 40th day post operation. Results The skin temperature difference between both sides of incision was （0.098±0.088）℃. On the cut side the skin temperature was higher than that of the other side (P<0.01). The scar thickness of cut side was (3.61±0.61)mm, the other side was (3.10±0.68) mm. The difference was significant (P<0.01). Conclusion The inflammatory reaction and formation of scar can be decreased by means of preserving superior epigastric vessels in Cohen incision.
【Key words】 Cesarean section Inflammation Cicatrix Methods
改良筋膜横切口也称为Cohen切口，适用于剖宫产和子宫切除术。其特点为沿腹壁Lnger线浅切开下腹部皮肤，钝性分离皮下筋膜，保留皮下粗大的血管［1］。 我院自1996年6月开始在剖宫产术中应用此方法，对部分病例在术后应用远红外线计算机化热成像（computer electric infrared thermovision video system，CET)仪，对皮肤切口进行测温分析，并测量切口瘢痕厚度，客观地对[1] [2] 下一页
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