腭裂术后松弛切口不同处理方法的疗效对比研究

Different management of relaxed incision in cleft palate surgery

摘要:

目的 对比腭裂患者整复术中创面不同的处理方法对伤口愈合效果的影响。方法 184 例腭裂手术患者，随机分为3 组。A 组采用明胶海绵填塞创面，B 组采用生物蛋白胶填充松弛切口，C 组应用碘仿纱包及碘仿纱条填塞创面。评价3 组术后精神、饮食恢复时间的差异及术后发热、出血情况。结果 A 组、B组各项指标比较，差异无统计学意义（P >0.05），3 组在术后发热率、术后出血率、术后发热天数、术后第1天精神及进食恢复率、术后呕吐发生率、松弛切口处瘢痕条索宽度及术后住院时间比较，差异有统计学意义（P <0.05）。3 组术后感染穿孔、复裂发生率比较，差异无统计学意义（P >0.05）。结论 明胶海绵与生物蛋白胶止血可靠，术后反应轻，伤口愈合快，具有良好的临床应用价值。

Abstract:

Objective To compare the effect of different treatment methods on wound healing of the relaxation incisions of palatorrhaphy. Methods A total of 184 patients receiving cleft palate surgery were selected and randomly divided into three groups. The bilateral relaxed incisions were treated with gelatin sponge in the group A,with biomedical fibrin glue in the group B, and with iodoform gauze in the group C. After operation, the recovery time, temperature, diet status, wound healing and bleeding etc were evaluated. Results There was no significant difference in each index between the group A and the group B (P > 0.05). There were significant differences in the rates of postoperative fever, hemorrhage and vomitting, the number of days of postoperative fever, the rates of mental recovery and food-intake recovery on the 1st day after operation, the scar width at loose incision, and the time of postoperative hospitalization among the 3 groups (P < 0.05). There was no significant difference in the incidence of postoperative infection, perforation or cleft recurrence among the three groups (P > 0.05). Conclusions Gelatin sponge and biomedical fibrin glue have good clinical application value in management of relaxed incisions with the advantages of good hemostasis, quick diet recovery and wound healing.