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妇科手术时对指定的非美容性腹壁成形术的评估。

Evaluation of indicated non-cosmetic panniculectomy at time of gynecologic surgery.

作者信息

Rasmussen Ryan W, Patibandla Jay R, Hopkins Michael P

机构信息

Department of Obstetrics and Gynecology, Aultman Health Foundation, Northeast Ohio Medical University, Canton, OH, USA.

出版信息

Int J Gynaecol Obstet. 2017 Aug;138(2):207-211. doi: 10.1002/ijgo.12207. Epub 2017 May 31.

Abstract

OBJECTIVE

To report postoperative outcomes among patients undergoing indicated non-cosmetic panniculectomy at the time of gynecologic surgery.

METHODS

Medical charts were retrospectively reviewed for patients who underwent panniculectomy coupled with gynecologic surgery at a university-affiliated hospital in the USA in 1990-2014. The data reviewed included age, body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters), surgical procedure, estimated blood loss, pathology, wound complication, diabetes, hypertension, smoking, and readmission rate. One-way analysis of variance and logistic regression were used to evaluate the data.

RESULTS

In total, 300 patients underwent panniculectomy; the mean age was 51 years and the mean BMI was 46. Overall, there were 94 (31.3%) complications, including 85 (28.3%) cases of superficial cellulitis and 9 (3.0%) cases of surgical-site infection. In logistic regression, diabetes, hypertension, and smoking were significant predictors of wound complications, identifying 78% of women who subsequently developed wound complications.

CONCLUSION

Panniculectomy combined with gynecologic surgery was found to be safe and effective for obese patients, with an acceptable incidence of wound infection. History of diabetes, hypertension, and smoking increased the risk of postoperative wound complications. These factors will help to predict patients at risk of wound complication.

摘要

目的

报告在妇科手术时接受非美容目的腹壁成形术患者的术后结局。

方法

对1990年至2014年在美国一家大学附属医院接受腹壁成形术联合妇科手术的患者病历进行回顾性分析。所回顾的数据包括年龄、体重指数(BMI,计算方法为体重(千克)除以身高(米)的平方)、手术方式、估计失血量、病理、伤口并发症、糖尿病、高血压、吸烟情况及再入院率。采用单因素方差分析和逻辑回归分析对数据进行评估。

结果

共有300例患者接受了腹壁成形术;平均年龄为51岁,平均BMI为46。总体而言,有94例(31.3%)出现并发症,包括85例(28.3%)浅表蜂窝织炎和9例(3.0%)手术部位感染。在逻辑回归分析中,糖尿病、高血压和吸烟是伤口并发症的显著预测因素,可识别出78%随后发生伤口并发症的女性。

结论

腹壁成形术联合妇科手术对肥胖患者是安全有效的,伤口感染发生率可接受。糖尿病、高血压和吸烟史会增加术后伤口并发症的风险。这些因素有助于预测有伤口并发症风险的患者。

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