外阴恶性肿瘤腹股沟淋巴结清扫术后腹股沟区创面处理的临床观察

目的 探讨外阴恶性肿瘤腹股沟淋巴结清扫术手术切口的改良缝合法及腹腔镜下腹股沟淋巴结清扫术的可行性。方法 回顾性分析外阴恶性肿瘤腹股沟淋巴结清扫术手术切口的改良缝合法（改良组）与传统缝合法（传统组）及腔镜下腹股沟淋巴结清扫术（腔镜组）的腹股沟切口的平均愈合时间、Ⅰ期愈合率及延迟愈合率。结果 传统缝合法的16例患者平均愈合时间为（28.0±19.2）天，其中6例为Ⅰ期愈合；改良缝合法的9例患者平均愈合时间为（14.2±6.2）天，其中8例为Ⅰ期愈合；16例腔镜法手术的腹股沟创面的Ⅰ期愈合率为93.8％（其中1例合并糖尿病者延期愈合）。传统组的平均愈合时间显著长于改良组（P＜0.05）。3组延迟愈合率分别为62.5％、11.1％和6.2％，传统组显著高于改良组和腔镜组（P＜0.05），腔镜组与改良组相比差异无统计学意义（P＞0.05）。 结论 外阴恶性肿瘤腹股沟淋巴结清扫术后腹股沟区皮肤切口的改良缝合法和腔镜下腹股沟淋巴结清扫术后的腹股沟皮肤的愈合情况均显著优于传统缝合方法，值得临床推广和应用。

Clinical observation of groin incision healing after inguinal lymphadenectomy of vulvar cancer

Objective To explore the feasibility of malignant inguinal lymphadenectomy improving surgical incision under the suture and laparoscopic inguinal lymph node dissection of the vulva cancer. Methods A retrospective analysis on groin incision healing time,healing rate of stageⅠ and delayed healing rate were made among the following three groups： improved suture skill group,traditional suture skill group and endoscopic inguinal lymphadenectomy group. Results The average healing time of a groin incision in traditional group of 16 patients was（ 28. 0 ± 19. 2） d,including 6 cases with healing at stageⅠ; and the average healing time of 9 patients in improved group was（ 14. 2 ± 6. 2） d and 8 cases healed at stageⅠ. The healing rate at stageⅠ in laparoscopic group of 16 cases was 93. 8%（ 1 patient with diabetes delayed healing）. The average healing time in traditional group was significantly longer than those in the other two groups（ P 〈 0. 05）. The delay healing rate of traditional group was 62. 5%,significantly higher than 11. 1%,6. 2% of improved group and laparoscopic group（ P 〈 0. 05）,but there was no significant difference between improved group and laparoscopic group in the delay healing rate（ P 〉 0. 05）. Conclusion The improved suture methods and laparoscopic inguinal lymphadenectomy surgical methods are better than the traditional suture method on skin incision healing of the groin area,which is worth of popularizing and applying.