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目的探讨大黄、芒硝治疗剖宫产腹部切口愈合不良的临床疗效。方法回顾性分析1290例剖宫产切口愈合不良患者资料,对其切口愈合不良的原因进行观察,总结出肥胖、贫血、妊娠期水肿、滞产、术时麻醉效果不良、腹部多次手术者为切口愈合不良的高危因素,其中46例有愈合不良高危因素患者,于术后48 h采用中药大黄、芒硝外敷腹壁切口。观察其临床疗效。结果 46例患者中45例为Ⅰ期愈合,其中35例于术后切口出现红肿和硬结,11例腹壁水肿仍较重;经用药2~4 d后水肿消退,红肿和硬结消失,切口拆线Ⅰ期愈合,痊愈出院。1例肥胖、重度贫血、低蛋白血症患者伤口渗液,部分裂开后,经局部敷药延期愈合,治愈率97.83%,伤口愈合不良占总剖宫产的0.45%。结论大黄、芒硝外敷防治剖宫产切口愈合不良效果确切,值得临床推广应用。
Objective To investigate the clinical effects of rhubarb and mirabilite in treating cesarean section abdomen incision healing. Methods A retrospective analysis of 1,290 cases of cesarean section incision poor healing data, the reasons for the incision healing were observed to summarize the obesity, anemia, edema during pregnancy, prolonged labor, poor anesthesia, multiple abdominal surgery were Incision poor risk factors for healing, of which 46 cases of patients with high risk factors for hemolysis, 48 h after the use of traditional Chinese medicine rhubarb, mirabilite external abdominal incision. Observe its clinical efficacy. Results Of the 46 patients, 45 cases were stage Ⅰ healed, among them, 35 cases showed redness and induration after operation incision, and 11 cases had severe abdominal wall edema. Edema disappeared, swelling and induration disappeared after 2-4 days, Stage Ⅰ healed, discharged. One case of obesity, severe anemia, hypoalbuminemia wound exudate, partial dehiscence, the local dressing delayed healing, the cure rate was 97.83%, poor wound healing accounted for 0.45% of the total cesarean section. Conclusion rhubarb, mirabilite topical prevention and treatment of cesarean section incision healing is ineffective, worthy of clinical application.