滕艳 潘静

[摘要]目的：探究美容缝合法对会阴侧切愈合以及切口的影响。方法：选取2019年3月-2020年1月笔者医院行会阴侧切术的60例产妇作为研究对象，根据信封密封法随机分为两组，分别为对照组（n=30，会阴外缝合技术）及观察组（n=30，皮下美容缝合法），统计两组产妇切口愈合情况、切口肿胀程度、疼痛程度、美观满意度及感染情况。结果：观察组感染例数、手术缝合时间、平均出血量、肿胀程度及线结反应均少于对照组，差异有统计学意义（P<0.05）。术后第3天，观察组产妇VAS为（3.67±2.24）分，对照组为（5.12±3.17）分，差异有统计学意义（P<0.05）。观察组产妇切口甲级愈合较对照组多，美观满意度评分较对照组高，差异有统计学意义（P<0.05）。结论：皮下美容缝合法应用于会阴侧切术中，切口愈合效果较佳，具有美观、操作简单、舒适等优点，值得推广。

[关键词]皮下美容缝合法;会阴侧切;切口愈合;感染;肿胀程度;线结反应

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）01-0032-03

Application and Effect of Subcutaneous Cosmetic Suture in the Treatment of Lateral Episiotomy

TENG Yan，PAN Jing

（Department of Obstetrics and Gynecology，Wuhu Fifth People's Hospital，Wuhu 241000，Anhui，China）

Abstract： Objective  To explore the effect of cosmetic suture on perineal side incision healing and incision. Methods  A total of 60 cases of pregnant women who underwent perineal incision in our hospital from March 2019 to January 2020 were selected as the study subjects. According to the envelope sealing method， they were randomly divided into two groups： the control group （n=30， perineal external suture） and the observation group （n=30， subcutaneous cosmetic suture）. Incision healing， incision swelling， pain， aesthetic satisfaction， and infection were compared between the two groups. Results  The number of infection cases， operation suture time， average blood loss， swelling degree and suture reaction in the observation group were less than those in the control group， and the differences were statistically significant（P<0.05）. On the third day after operation， the VAS of the observation group was （3.67±2.24）， and that of the control group was （5.12±3.17）， the difference was statistically significant（P<0.05）. The observation group had more cases of Grade A wound healing than the control group， and the aesthetic satisfaction score was higher than that of the control group（P<0.05）. Conclusion  Subcutaneous cosmetic suture is applied in lateral episiotomy， the effect of incision healing is better， with the advantages of beauty， simple operation and comfort， which is worthy of promotion.

Key words： subcutaneous cosmetic suture; lateral episiotomy; wound healing; infection; swelling degree; suture reaction

會阴侧切术是产科中常见的助产术式，其作用是避免盆底组织裂伤或者会阴裂伤，而且能够避免盆底组织松弛，减少尿失禁、直肠膨出、膀胱膨出等情况，加快分娩进展，一般应用于母婴存在病理情况需要加快第二产程或者需要紧急结束分娩进程、胎儿过大或者会阴过紧等产妇分娩过程中[1]。术后切口恢复受到缝合技术、缝合材料等因素影响，目前临床实践证实可吸收缝合线能够被组织吸收，异物反应比较轻[2]。在缝合技术方面，传统缝合方法为间断缝合，影响侧切切口术后愈合，美容缝合法对皮下脂肪、基层及黏膜层都进行连续缝合，皮内美容缝合法有需中途换针及缝合困难的不足[3]。笔者医院将皮下美容缝合法应用于会阴侧切过程中，能够减缓疼痛，帮助产妇尽快坐立哺乳。为探究可吸收缝合线联合皮下美容缝合法对会阴侧切愈合以及切口的影响，详细报道如下。……