杜梦雨 章祥洲 赵玉婷

[摘要]目的：探討腹壁成形术对于产后腹壁松弛患者的治疗效果。方法：回顾性分析2017年3月-2019年3月在蚌埠市第三人民医院行腹壁成形术的患者15例，年龄（35.7±5.75）岁，均为女性。于术前、术后2周、术后6个月测量并记录患者经髂前上棘腹围、体重指数，观察患者术后并发症发生情况、腹壁美容效果以及患者手术满意度。术后随访6个月～1年。结果：15例患者均成功施行手术，术后腹壁松弛得以修复，术后2周经髂前上棘腹围为（79.2±4.93）cm，较术前（94.8±5.22）cm明显缩小，差异有统计学意义（P<0.05）。术后体重指数（Body mass index，BMI）为（22.2±1.77）kg/m2，较术前BMI（22.8±1.85）kg/m2有所减小，差异有统计学意义（P<0.05）。所有患者均无血清肿、感染、血肿、切口裂开、皮肤坏死等并发症发生。嘱患者控制体重，术后6个月腹围无明显增加。结论：腹壁成形术可明显改善产后腹壁松弛患者腹部外形，减小患者腹围和BMI，术后患者满意度高，对于产后腹壁松弛患者具有一定临床意义。

[关键词]腹壁成形术;脐孔重建;产后腹壁松弛;腹直肌分离;术后并发症

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）04-0081-04

Correction Effect of Abdominoplasty on Postpartum Patients with Abdominal Wall Relaxation

DU Meng-yu，ZHANG Xiang-zhou，ZHAO Yu-ting

（Department of Burn and Plastic Surgery，the Third Peoples Hospital of Bengbu Affiliated with Bengbu Medical College，Bengbu 233000，Anhui，China）

Abstract： Objective  To discuss the clinical effect of abdominoplasty on postpartum patients with abdominal wall relaxation. Methods  A retrospective analysis of 15 patients aged （35.7±5.75） years old who performed abdominoplasty at the Third People's Hospital of Bengbu from March 2017 to March 2019， all were female. The anterior superior iliac spine abdominal circumference and body mass index were measured and recorded before operation， 2 weeks after operation， and 6 months after operation. The occurrence of postoperative complications， the cosmetic effect of the abdominal wall， and the patient's surgical satisfaction were observed. The follow-up time was 6 months to 1 year. Results  All 15 cases were successfully operated， and the abdominal wall slack was repaired after operation. The abdominal circumference of the anterior superior iliac spine was （79.2±4.93）cm after 2 weeks， which was significantly smaller than the preoperative （94.8±5.22）cm. The difference was statistically significant （P<0.05）. Postoperative BMI  was （22.2±1.77）kg/m2， which was reduced compared with preoperative BMI （22.8±1.85）kg/m2， and the difference was statistically significant （P<0.05）. All patients had no complications such as seroma， infection， hematoma， incision split， skin necrosis and so on. The patients were instructed to control their weight， and their abdominal circumference did not increase significantly after 6 months. Conclusion  Abdominoplasty can conspicuously improve the abdominal shape of patients with postpartum abdominal wall relaxation， reduce the patient's abdominal circumference and BMI， and have a high degree of patient satisfaction after surgery.

Key words： abdominoplasty; umbilical perforation reconstruction; postpartum abdominal wall relaxation; the rectus diastasis; postoperative complications

女性妊娠后，随着体内雌、孕激素水平的变化及胎儿在宫内不断成长，腹壁被动膨隆，尤其到了孕晚期，过度的张力作用，会造成腹壁皮肤、肌肉及腱膜等组织的不可逆损伤，表现为腹壁皮肤和腱膜松弛、腹直肌分离等体征，不仅给患者带来一系列健康问题（如皮肤折返处反复摩擦、感染、湿疹、破溃、瘙痒、腰背痛等），因腹壁外观问题，还造成患者自卑、交际困难等一系列心理问题。为解决上述问题，重塑腹壁外形，笔者科室对15例生产造成的腹壁松弛患者施行腹壁成形术，效果显著，现报道如下。

1  资料和方法

1.1 一般资料：回顾性分析2017年3月-2019年3月在笔者科室行腹壁成形术的患者15例，年龄（35.7±5.75）岁，均为女性。其中12例患者曾行剖宫产术，1例3次剖宫产史，4例2次剖宫产史，1例患者有产双胞胎史，1例患者有吸烟史，所有患者均无饮酒史，无高血压、糖尿病等基础疾病史。……