Larson Christopher M, Ratzer Erick R, Davis-Merritt Deborah, Clark Jeffrey R
Department of Surgical Education, Exempla Saint Joseph Hospital, Denver, Colorado, USA.
Am Surg. 2009 Feb;75(2):169-71.
Abdominal binders are ordered by some surgeons postoperatively for patient comfort and to prevent wound complications. There has been some question as to the compressive effect that an abdominal binder has on pulmonary function. We prospectively randomized 54 patients undergoing a midline laparotomy incision to two groups: a "binder" group and a "no binder" group. Preoperative pulmonary function tests (vital capacity and incentive spirometry) were measured. Postoperatively, pulmonary function tests, pulse oximetry, oxygen requirement, pulmonary and wound complications, pain control, time to ambulation, and hospital length of stay were examined. Vital capacity as a per cent of preoperative values on postoperative Day 1 for the binder and nonbinder groups were 64.7 and 54.6 per cent, respectively, but this was not statistically significant. Average level of pain using the visual analog pain scale on postoperative Days 1 through 3 in the binder versus nonbinder groups was 4 versus 8, 3 vs 6, and 3 versus 7, respectively. Time to ambulation was 18.6 hours in the binder group and 16.7 hours in the nonbinder group. Hospital length of stay in the binder and nonbinder groups was 3.9 days and 3.7 days, respectively. We conclude that abdominal binders in our patients with midline abdominal incisions had no significant effect on postoperative pulmonary function, but seemed to help with pain control.
一些外科医生在术后会为患者开具腹带,以使其感觉舒适并预防伤口并发症。腹带对肺功能的压迫作用一直存在一些疑问。我们前瞻性地将54例行中线剖腹手术切口的患者随机分为两组:“腹带”组和“无腹带”组。测量术前肺功能测试(肺活量和激励肺活量测定)。术后,检查肺功能测试、脉搏血氧饱和度、氧气需求、肺部和伤口并发症、疼痛控制、下床活动时间以及住院时间。腹带组和无腹带组术后第1天的肺活量占术前值的百分比分别为64.7%和54.6%,但这无统计学意义。在术后第1天至第3天,腹带组与无腹带组使用视觉模拟疼痛量表的平均疼痛水平分别为4分对8分、3分对分6和3分对7分。腹带组的下床活动时间为18.6小时,无腹带组为16.7小时。腹带组和无腹带组的住院时间分别为3.9天和3.7天。我们得出结论,对于我们行中线腹部切口的患者,腹带对术后肺功能无显著影响,但似乎有助于疼痛控制。