高琛　吴兴花　陈锦果　林素蕊　张丽

[关键词] 腹腔镜;引流管;固定方法;引流口

[中图分类号] R713          [文献标识码] B          [文章编号] 1673-9701（2021）17-0078-03

Impacts of modified drainage tube fixation method and conventional fixation method on drainage port after gynecological laparoscopic surgery

GAO Chen   WU Xinghua   CHEN Jin′guo   LIN Surui   ZHANG Li

Department of Gynecology， Ningde Hospital Affiliated to Ningde Normal University，Ningde   352100，China

[Abstract] Objective To compare the impacts of modified drainage tube fixation method and conventional fixation method on drainage port after gynecological laparoscopic surgery. Methods The data of 50 patients with laparoscopic drainage tube fixed by conventional method in our department from January to December 2019 （the control group） and 50 patients with laparoscopic drainage tube fixed by modified method from January to November 2020 （the experimental group） were retrospectively analyzed. The general data and postoperative complications of the incision， such as non-closure of drainage port （on the day of extubation）， oozing blood and fluid， delayed healing （the drainage port failed to reach grade A healing after 4 days of operation）， infection， drainage tube falling off， and difficulty or fracture of extubation were compared between the two groups. Results On the comparison of general data， there were no statistically significant differences in age， body mass index （BMI） and preoperative hemoglobin between the experimental group and the control group（P>0.05）. On the comparison of postoperative indices，the proportion of non-closure of drainage port， oozing blood and fluid， and delayed healing in the experimental group was lower than those in the control group， with significant difference（P<0.05）. There was no infection in the drainage ports of the two groups， and there were no drainage tube falling off， or difficulty or fracture of extubation in the two groups. Conclusion The modified fixation method of drainage tube after laparoscopic surgery can reduce the incidence of complications of drainage port， which can be used as a reference for patients who need abdominal drainage in the laparoscopic surgery.

[Key words] Laparoscopy; Drainage tube; Fixation method; Drainage port

腹腔鏡手术是20世纪外科手术的里程碑，目前外科系统已普遍开展了腹腔镜手术，在妇科领域，腹腔镜手术成为不少妇科疾病的首选手术方式。临床循证医学证明，腹腔镜手术的优势越来越明显。近年来，随着加速康复外科（Enhanced recovery after surgery，ERAS）理念的推广，使得预防性腹腔引流存在争议[1]。然而，在一些复杂的外科治疗中，腹腔引流仍占据重要地位，腹腔引流是及时发现和判断术后可能出现并发症的常用监测手段。腹腔镜手术的理念是微创、美观、损伤小、恢复快，而传统的腹腔引流管固定方法常出现拔管后引流口不闭合、渗血、渗液、延期愈合等并发症，且引流口愈合瘢痕明显，影响美观，与腹腔镜手术理念相悖。我科2020年开始对腹腔镜术后引流管的固定方法进行改良，减少了引流口并发症的发生，现报道如下。

1 资料与方法

1.1 一般资料

收集2019年1—12月我科采用传统方法固定腹腔镜引流管患者50例作为对照组，2020年1—11月采用改良方法固定腹腔镜引流管患者50例作为实验组，回顾性分析两组患者的一般资料和术后切口并发症情况。

1.2 纳入及排除标准

纳入标准：①腹腔镜手术;②视术中情况需留置腹腔引流管者。排除标准：①非腹腔镜手术者;②腹腔镜手术视术中情况无需留置腹腔引流管者。

1.3 方法

1.3.1 手术方法  腹腔镜手术操作见文献[2]。

1.3.2 置管固定方法  ①传统固定方法：在右下腹……