| 摘要: |
| 目的观察采用透明质酸钠凝胶（HA）术前内皮黏膜覆盖及术后创面隔离法在预防妇产科手术后盆腹腔粘连的临床效果。方法回顾性分析行妇产科手术的患者7000例，根据术中是否应用HA分为实验组（3652例）和对照组（3348例）。实验组于术中病灶切除前，在病灶区域的内皮黏膜上及对应区域的腹膜上充分涂抹HA；病灶切除后再于创面涂抹HA。对照组患者按常规行手术，术中不应用HA。观察比较两组患者术后盆腹腔粘连发生情况。结果术后1周、3个月、6个月，实验组患者盆腹腔粘连发生率均低于对照组（均P＜0.05）。组间比较，无论是初次手术还是再次手术、微创手术还是开腹手术，实验组患者术后盆腹腔粘连发生率均低于对照组（均P＜0.05）；组内比较，实验组和对照组初次手术患者术后盆腹腔粘连发生率均低于再次手术患者（均P＜0.05），微创手术患者术后盆腹腔粘连发生率均低于开腹手术患者（均P＜0.05）。结论HA作为屏障制剂，在术前和术后分别于手术区域涂抹，能够有效预防妇产科手术后盆腹腔粘连的形成，值得临床推广使用。 |
| 关键词: 透明质酸钠凝胶 妇产科手术 盆腹腔粘连 |
| DOI：10.12056/j.issn.1006-2785.2017.39.02.2015-1586 |
| 分类号: |
| 基金项目:吴阶平医学基金会临床科研专项资助基金课题（2011-LK10008） |
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| Application of sodium hyaluronate gel during gynecologic and obstetric surgery prevents postoperative pelvic or abdominal adhesion |
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PAN Yihong, CHENG Ya, LIN Weiping, LIN Huimin, XIE Jirong, JIN Furong, TAO Junzhen, SHI Chunjuan, LI Jin
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Taizhou Central Hospital
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| Abstract: |
| Objective To observe the effect of sodium hyaluronate gel (HA) on postoperative pelvic or abdominal adhesion in gynecologic and obstetric surgery. Methods Clinical data of 7 000 patients undergoing gynecologic and obstetric surgery were retrospectively analyzed. HA was applied and fully coated on the lesions and corresponding peritoneum before resection and on the surface of the wound after resection in 3 652 cases (HA group), while HA was not applied during operation in 3 348 cases (control group). The occurrence of postoperative pelvic or abdominal adhesion were observed and compared between two groups. Results The overall incidence rates of pelvic or abdominal adhesion in HA group were lower than those in control group (P＜0.05) 1 week, 3 months and 6 months after surgery. The incidence rates of pelvic or abdominal adhesion in patients with initial operation were lower than those in patients with reoperation, the incidence rates in patients with minimally invasive surgery were lower than patients with open surgery (all P＜0.05) both in HA group or control group. Conclusion HA as a barrier preparation applied during gynecologic and obstetric surgery can effectively prevent postoperative pelvic or abdominal adhesions. |
| Key words: Sodium hyaluronate gel Gynecological surgery Pelvic or abdominal adhesion |
