冯小珊 胡荣

[摘要]目的：探究皮膚护理多元改良模式联合硅凝胶疤痕贴片对剖宫产术后切口的影响。方法：选取2018年12月-2019年2月于阜阳市妇女儿童医院行剖宫产术的60例产妇作为研究对象，将其按照随机数表法分为干预组（n=30）和对照组（n=30），干预组术后使用硅凝胶疤痕贴片覆盖切口并行皮肤护理多元改良模式，对照组术后无菌敷料覆盖切口并行皮肤护理多元改良模式。术后1周采用WongBanker面部表情量表（Faces pain scale-Revised，FPS-R）和舒适状况量表（General comfort questionnaire，GCQ）对比两组产妇的切口疼痛程度及舒适度，术后随访6个月采用温哥华瘢痕评估量表（Vancouver scar scale，VSS）对比两组产妇切口瘢痕情况。结果：术后1周，干预组产妇的切口疼痛及舒适度情况优于对照组，差异有统计学意义（P<0.05）。术后随访6个月，干预组温哥华瘢痕评估量表评分、瘢痕平均厚度明显低于对照组，差异有统计学意义（P<0.05）。结论：皮肤护理多元改良模式联合硅凝胶疤痕贴片有助于促进剖宫产术后切口愈合，减轻术后切口疼痛，提高术后产妇舒适度，抑制瘢痕增生，促进瘢痕修复，值得临床推广。

[关键词]皮肤护理多元改良模式;硅凝胶疤痕贴片;剖宫产;切口修复;瘢痕

[中图分类号]R473.71    [文献标志码]B    [文章编号]1008-6455（2021）05-0159-03

Study on the Effect of Skin Nursing Multi Improved Model Combined with Silicone Gel Scar Patch on Incision after Cesarean Section

FENG Xiao-shan，HU Rong

（Department of Obstetrics and Gynecology，Fuyang Women and Children Hospital，Fuyang 236000，Anhui，China）

Abstract： Objective  To study the effect of skin nursing multi improved model combined with silicone gel scar patch on incision after cesarean section. Methods  A total of 60 pregnant women who underwent cesarean section in Fuyang women and children's Hospital from December 2018 to February 2019 were selected and divided into the intervention group （n=30） and the control group （n=30） randomly according to the random number table method. The intervention group was treated with silicone gel scar patch covering the incision and skin nursing multi improved model. In the control group， the incision was covered with sterile dressing and skin nursing multi improved model. One week after the operation， Faces pain scale-Revised （FPS-R） and general comfort questionnaire（GCQ） were used to compare the degree of incision pain and comfort between the two groups. Six months after the operation， Vancouver scar scale （VSS） was used to compare the scar condition of the two groups. Results  One week after surgery， the intervention group's maternal incision pain and comfort were better than the control group， the differences were statistically significant （P<0.05）. The follow-up 6 months after operation， the scores of VSS and average thickness of scar in the intervention group were significantly lower than those in the control group （P<0.05）. Conclusion  Skin nursing multi improved model combined with silicone gel scar patch can help to promote incision healing after cesarean section， reduce postoperative incision pain， improve postoperative comfort， inhibit scar hyperplasia and promote scar repair， which is worthy of clinical promotion.

Key words： skin nursing multi improved model; silicone gel scar patch; cesarean section; incision repair; scar

随着近年健康意识的提高，剖宫产产妇对术后切口恢复和瘢痕增生愈发关注[1]。剖宫产手术切口的愈合是否良好，瘢痕增生是否明显一方面取决于术后切口处理方式，另一方面则与术后切口护理密切相关。近年来，医用生物贴剂在手术切口瘢痕修复中的研究逐步增多，硅凝胶疤痕贴片是以硅凝胶为主要材料的敷料，其具有良好的透气性、拉伸性及粘性[2]，可作用于瘢痕组织表面，增加局部渗透压，减少蛋白质的内部沉积，一定程度上抑制瘢痕组织增生[3-4]，促进瘢痕修复，既往多用于面部手术术后瘢痕增生防治、烧伤瘢痕修复等方面，在剖宫产术后切口瘢痕修复中的研究相对较少。……