单术者心脏起搏器植入不同缝合方法的临床研究

目的对比单术者心脏永久起搏器植入术切口采用不同缝合方法的差异。方法 2011年1月—2013年10月行单术者心脏永久起搏器植入术380例,随机分为连续缝合组和间断缝合组,每组各190例,观察并比较术中两种方法切口缝合时间、术后住院时间、囊袋血肿和感染发生率及切口愈合情况。结果连续缝合组手术切口缝合时间明显短于间断缝合组,差异有统计学意义(P0.01)。术后2周两组囊袋血肿发生率及术后住院时间比较差异均无统计学意义(P0.05),且两组均无囊袋感染病例。术后3个月内连续缝合组未见皮肤线头外露,间断缝合组皮肤线头外露6例(3.16%),组间比较差异有统计学意义(P0.05);两组手术切口均愈合良好。结论单术者起搏器植入术切口应用连续缝合法具有缝合时间短、无线头外露的优势,可作为单术者起搏器植入的常规缝合方法。

Comparison of Different Suture Procedures for Closure of Skin Incision in Cardiac Pacemaker Implantation by One Operator

Objective To compare different suture procedures for the closure of the skin incision in performing cardi-ac pacemaker implantation by one operator. Methods During the period from January 2011 to October 2013, a total of 380 patients were admitted to our hospital to receive permanent cardiac pacemaker implantation and only one operator performed the operation. The patients were randomly divided into two groups （ continuous suture group and interrupted suture group） , each group included 190 patients. The suture time, postoperative hospitalization days, incidence of pocket hematoma and infection, as well as the healing condition of the incision were recorded and compared between the two groups. Results The suture time of continuous suture group was markedly shorter than that of interrupted suture group （P〈0. 01）. The incidence of pocket he-matoma in continuous suture group was similar to that in interrupted suture group, and the difference was not significant （ P〉0. 05）, and no significant difference in the postoperative hospitalization days existed between the two groups （P〉0. 05）. No pocket infection occurred in the two groups. During three months after the operation, suture line leakage was found in six pa-tients （3. 16%） in interrupted suture group while no patient in continuous suture group （P〈0. 05）. The skin incision was well healed in all patients of both groups. Conclusion Continuous suture has advantages of shorter suture time and lower su-ture line leakage rate, which can be the routine suture method for pacemaker implantation by one operator.