ﺑﺮرﺳﻲ ﻣﻘﺎﻳﺴﻪ اي ﺗﺄﺛﻴﺮ ﺑﺮش ﻫﺎي ﻋﺮﺿﻲ و ﺧﻂ وﺳﻂ ﺷﻜﻢ ﺑﺮ ﭘﺎراﻣﺘﺮﻫﺎي ﺗﻨﻔﺴﻲ اﺳﭙﻴﺮوﻣﺘﺮي در ﺑﻴﻤﺎرﺳﺘﺎن اﻟﺰﻫﺮاء اﺻﻔﻬﺎن

Comparison of the Effect of Transverse and Midline Incisions of Abdomen on Respiratory Parameters in Al-Zahra Hospital (Isfahan)

ﺯﻣﻴﻨﻪ ﻭ ﻫﺪﻑ: ﺑﺮﺵ ﻋﺮﺿﻲ ﻭ ﺧﻂ ﻭﺳﻂ ﺷﻜﻢ ﺩﻭ ﺭﻭﺵ ﻣﺘﺪﺍﻭﻝ ﺩﺭ ﺟﺮﺍﺣﻲ ﻫﺎﻱ ﻏﻴﺮ ﺍﻭﺭﮊﺍﻧﺴﻲ ﻧﺎﺣﻴﻪ ﻓﻮﻗﺎﻧﻲ ﺷﻜﻢ ﺍﺳﺖ. ﺍﻳﻦ ﺩﻭ ﺭﻭﺵ ﺩﺍﺭﺍﻱ ﺗﺎﺛﻴﺮﺍﺕ ﺍﺧﺘﺼﺎﺻﻲ ﺧﻮﺩ ﺑﺮﻛﺎﺭﻛﺮﺩ ﺟﺪﺍﺭﻩ ﺷﻜﻢ ﻫﺴﺘﻨﺪ ﻛﻪ ﺍﻳﻦ ﺗﺄﺛﻴﺮ ﺑﻪ ﺻﻮﺭﺕ ﺗﻐﻴﻴﺮ ﺩﺭ ﭘﺎﺭﺍﻣﺘﺮﻫﺎﻱ ﭘﺎﺭﺍﻛﻠﻴﻨﻴﻜﻲ ﻭﻛﻠﻴﻨﻴﻜﻲ ﭘﺲ ﺍﺯ ﻋﻤﻞ ﺑﻴﻤﺎﺭ ﺍﺯ ﺟﻤﻠﻪ ﻛﺎﺭﻛﺮﺩ ﺭﻳﻮﻱ، ﺩﺭﺩ ﻭ ﺍﻟﺘﻴﺎﻡ ﺯﺧﻢ ﻧﻤﺎﻳﺎﻥ ﻣﻲ ﺷﻮﺩ. ﻣﺎ ﺩﺭ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺑﻪ ﻣﻘﺎﻳﺴﺔ ﺗﺄﺛﻴﺮ ﺑﺮﺵ ﻫﺎﻱ ﻋﺮﺿﻲ ﻭ ﺧﻂ ﻭﺳﻂ ﺷﻜﻢ ﺑﺮ ﻛﺎﺭﻛﺮﺩﻫﺎﻱ ﺭﻳﻮﻱ ﺑﻴﻤﺎﺭﺍﻥ ﭘﺮﺩﺍﺧﺘﻴﻢ.ﻣﻮﺍﺩ ﻭ ﺭﻭﺵ ﻫﺎ: ﺩﺭ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺗﻌﺪﺍﺩ 70 ﻧﻔﺮ ﺍﺯ ﺑﻴﻤﺎﺭﺍﻧﻲ ﻛﻪ ﺩﺭ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﺍﻟﺰﻫﺮﺍﺀ ﺍﺻﻔﻬﺎﻥ ﺗﺤﺖ ﻋﻤﻞ ﺟﺮﺍﺣﻲ ﻏﻴﺮ ﺍﻭﺭﮊﺍﻧﺴﻲ ﻗﺴﻤﺖ ﻓﻮﻗﺎﻧﻲ ﺷﻜﻢ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻪ ﺑﻮﺩﻧﺪ، ﺩﺭ ﺩﻭ ﮔﺮﻭﻩ )ﮔﺮﻭﻩ ﺑﺮﺵ ﻋﺮﺿﻲ 35 ﺑﻴﻤﺎﺭ ﻭ ﮔﺮﻭﻩ ﺑﺮﺵ ﺧﻂ ﻭﺳﻂ 35 ﺑﻴﻤﺎﺭ( ﻣﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻨﺪ. ﻣﺎ ﺑﺎ ﺍﻧﺠـﺎﻡ ﺩﺍﺩﻥ ﺩﻭ ﺍﺳﭙﻴـﺮﻭﻣﺘﺮﻱ ﺍﺯ ﺗﻤﺎﻡ ﺑﻴﻤﺎﺭﺍﻥ ﭘﺎﺭﺍﻣﺘـﺮﻫﺎﻱ ﻇﺮﻓﻴﺖ ﺣﻴﺎﺗﻲ ﺑﺎ ﻓﺸﺎﺭ [Forced Vital Capacity (FVC)]، ﺣﺠـﻢ ﺑﺎﺯﺩﻣـﻲ ﺑﺎ ﻓﺸـﺎﺭ ﺩﺭ ﺛﺎﻧﻴﻪ ﺍﻭﻝ [Forced Expiratory Volume in 1 Second (FEV1)] ﻭ ﻧﺴﺒﺖ FEV1/FVC ﺭﺍ ﻗﺒﻞ ﻭ ﺑﻌﺪ ﺍﺯ ﻻﭘﺎﺭﺍﺗﻮﻣﻲ ﺗﻌﻴﻴﻦ ﻧﻤﻮﺩﻳﻢ. ﺩﺭ ﭘﺎﻳﺎﻥ ﻣﻄﺎﻟﻌـﻪ ﺗﻤـﺎﻡ ﺩﺍﺩﻩ ﻫﺎﻱ ﺟﻤـﻊ ﺁﻭﺭﻱ ﺷﺪﻩ ﺗﻮﺳـﻂ ﻧﺮﻡ ﺍﻓـﺰﺍﺭ ﺁﻣﺎﺭﻱ SPSS 13 ﻣـﻮﺭﺩ ﺗﺠـﺰﻳﻪ ﻭ ﺗﺤﻠﻴـﻞ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻨﺪ ﻭ 0/05

Introduction & Objective: Transverse and midline abdominal incisions are both commonly used for elective major upper abdominal surgery. Both incisions have specific effects on abdominal wall function, leading to postoperative differences in clinical parameters such as pulmonary function, pain and wound healing. We conducted a prospective study to compare the effects of midline and transverse incision on pulmonary function. Materials & Methods: We studied 70 patients undergoing elective upper abdominal surgery in two groups: transverse group (35 patients) and midline group (35 patients). The parameters of forced vital capacity (FVC) forced. Expiratory volume in one second (FEV1) and the ratio of FEV1/FVC were measured in all patients before and after laparotomy by two spirometries. Finally the SPSS (version 13) was used for completing all the statistical analyses, and P< 0.05 was considered as significant. Results: The mean in all parameters decreased after laparatomy in both groups, but the decrease in midline incision was significantly higher than the case of transverse Incision (P<0.05). Conclusions: Transverse incisions in abdominal surgery are based on better anatomical and physiological principles. Thus, this incision is the preferred for upper abdominal surgery.