皮下美容缝合技术在剖宫产术后切口处理中的应用效果

鲍红玉 李桂花

[摘要]目的：探究皮下美容縫合技术在剖宫产术后切口处理中的应用。方法：笔者医院2017年1月-2019年4月收治的152例产妇，按照随机数表法分为观察组与对照组，各76例。对照组采用常规缝合技术，观察组采用皮下美容缝合技术。比较两组治疗效果、手术相关指标、术后疼痛视觉模拟评分（Visual analogue scale，VAS）、不良反应发生率及切口愈合等级。结果：观察组总有效率为96.05%，对照组为80.26%，差异有统计学意义（P<0.05）。观察组切口缝合时间、手术时间显著短于对照组，差异有统计学意义（P<0.05）;两组切口长度比较，差异无统计学意义（P>0.05）。两组术后7d、30d两组VAS评分呈下降趋势，观察组相同时间点均低于对照组（P<0.05）。观察组切口瘢痕增生率、瘢痕宽度、瘢痕最薄厚度均低于对照组，差异有统计学意义（P<0.05）。观察组与对照组不良反应发生率分别为3.95%、15.79%，差异有统计学意义（P<0.05）。观察组切口愈合甲级为97.37%，而对照组为93.42%，但组间比较差异无统计学意义（P>0.05）。结论：皮下美容缝合技术用于剖宫产可有效提高切口愈合质量，显著改善瘢痕形成和术后疼痛，减少并发症发生，值得推广应用。

[关键词]剖宫产;瘢痕;并发症;美容缝合技术;切口愈合

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2020）05-0100-04

Abstract： Objective  To investigate the application of subcutaneous cosmetic suture technique in incision treatment after cesarean section. Methods  152 women who were admitted to our hospital between January 2017 and April 2019 were divided into the observation group and the control group according to the random number table method， 76 cases each group. The control group was used a conventional suture technique， and the observation group was used a subcutaneous cosmetic suture technique. The therapeutic effects， surgical related indexes， postoperative VAS scores， adverse reaction rates， and incision healing grades were compared between the two groups. Results  The total effective rate was 96.05% in the observation group and 80.26% in the control group， the difference was statistically significant （P<0.05）. The incision time and operation time of the observation group were significantly shorter than those of the control group （P<0.05）. There was no significant difference in incision length between the two groups （P>0.05）. The VAS score of the observation group was lower than that of the control group at the same time （P<0.05）. The hypertrophic rate， width and thickness of scar in the observation group were lower than those in the control group （P<0.05）. The incidence of adverse reactions was 3.95% in the observation group and 15.79% in the control group， the difference was statistically significant （P<0.05）. The incision healing of the observation group was 97.37%， while that of the control group was 93.42%， but there was no significant difference between the two groups （P>0.05）. Conclusion  Subcutaneous cosmetic suture technique for cesarean section can effectively improve the quality of incision healing， significantly improve scar formation and postoperative pain， and reduce complications. It is worthy of popularization and application.

Key words： cesarean section; scar; complications; cosmetic suture technique; incision healing

剖宫产是产科临床常用的手术方式[1]。现在产妇对剖宫产后切口愈合的美学需求越来越高，所以，在临床中如何减轻剖宫产术后切口瘢痕的形成成为当下研究重点[2]。常规缝合技术采用间断褥式缝合，术后有切口愈合差、疼痛、瘢痕增生等问题，美观效果差[3]。研究[4]发现，皮下美容缝合技术采用可吸收缝线缝合，可有效改善愈合质量，术后不用拆线，并可减少瘢痕组织增生。本研究选择笔者医院2017年1月-2019年4月收治的152例产妇进行对比研究，探讨皮下美容缝合技术在剖宫产术后切口处理中的应用效果。

1  资料和方法

1.1 一般资料：选取笔者医院152例产妇，随机分为观察组（76例）和对照组（76例）。两组产妇年龄、孕周、身体质量指数（Body mass index，BMI）、住院时间比较差异均无统计学意义（P>0.05），组间具有可比性，见表1。本……