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目的 评价横切口腹膜外单层缝合法在阑尾切除术中的临床应用效果。方法 2004年8月至2006年12月南方医科大学附属郴州医院和中山大学附属第三医院行724例右下腹切口阑尾切除术，随机采用横切口腹膜外单层缝合或常规麦氏（或横）切口分层缝合方法，对其疗效进行对比分析。结果 采用横切口腹膜外单层缝合法（单层缝合组）行化脓性、坏疽性阑尾切除者，其手术时间、术后住院时间、切口感染率等方面明显低于常规分层缝合法者（分层缝合组）（P〈0.01）；两组术后疼痛程度差异无统计学意义（P〉0.05）。单纯性阑尾炎切除病人中。横切口腹膜外单层缝合法与常规分层缝合法比较，临床效果无优越性（P〉0.05），疼痛程度明显增加（P〈0．01）。结论 右下腹横切口腹膜外单层缝合法具有操作简单、安全、并发症少的优点，应做为化脓性和坏疽性阑尾炎开腹阑尾切除术的标准方法。右下腹切口的分层缝合法应做为单纯性阑尾炎开腹阑尾切除术的首选方法。

Clinical evaluation of the transverse abdominal incision sutured by one-layer outside peritoneum in open appendectomy

??Objective:To assess the transverse abdominal incision sutured by one??layer outside peritoneum in open appendectomy. Methods:In a random??controlled study,724 patients underwent open appendectomy for appendicitis from August 2004 to December 2006 were analyzed.The patients were operated randomly with the transverse incisions sutured by one??layer outside peritoneum in the down??right abdominal part(group A)or with the routine McBurney's incision (or transverse abdominal incision ) sutured by multi??layer(group B). Results:In the patients with suppurative or gangrenous appendicitis,those in group A had significantly shorter operating time,shorter length of hospital stay and lower rates of incision infection than those in group B (P??0.01);however,the differential postoperative pain in the two groups was not found (P??0.05).In the patients with simple acute appendicitis,those in group A got no more advantages than that in group B (P??0.05),but also accompanied with more severe postoperative pain (P??0.01). Conclusion:In the patients underwent open appendectomy for suppurative or gangrenous appendicitis,the transverse incision sutured by one??layer outside peritoneum in the down??right abdominal part is safe and simple,and can provide more advantages than the routine incision sutured by multi??layer,which should be taken as a standard incision.However,in the patients with simple acute appendicitis,the routine McBurney’s incision (or transverse abdominal incision) sutured by multi??layer should be selected firstly.