邢燕燕 曹娇

[摘要]目的：探討会阴侧切皮下美容缝合术联合综合护理干预对产后切口愈合的影响。方法：选取2018年4月-2019年4月接诊的顺产会阴侧切初产妇60例，按照随机数字表法分成两组，对照组30例采用会阴侧切皮下美容缝合术联合常规护理配合，观察组30例在围术期联合综合护理干预，对比两组产妇总产程时间、产后48h会阴疼痛情况、切口愈合时间，记录两组产妇产后4周内线结反应，产后3个月、6个月时采用温哥华瘢痕评价量表（Vancouver scar scale，VSS）、患者瘢痕自我评分（Patient scar assessment scale，PSAS）评估侧切口的美观度。结果：观察组总产程、产后48h会阴疼痛程度优于对照组，差异有统计学意义（P<0.05）。观察组会阴侧切口一期愈合率略高于对照组，组间比较差异无统计学意义（P>0.05）。产后4周内观察组结线反应发生率显著低于对照组，差异有统计学意义（P<0.05）。产后3个月、6个月时观察组VSS评分、PSAS评分均显著低于对照组，差异有统计学意义（P<0.05）。结论：会阴侧切皮下美容缝合术联合综合护理能够有效缩短初产妇生产时间、缓解产后疼痛，切口愈合快，美观度和安全性较高。

[关键词]综合护理;初产妇;会阴侧切皮下美容缝合;顺产;美观度;瘢痕

[中图分类号]R473.71    [文献标志码]B    [文章编号]1008-6455（2021）07-0162-03

Study on the Effect of Perineal Lateral Incision and Subcutaneous Cosmetic Suture Combined with Comprehensive Nursing Intervention on Postoperative Incision Healing

XING Yan-yan，CAO Jiao

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

Abstract： Objective  To investigate the effect of subcutaneous cosmetic suture combined with comprehensive nursing intervention on the perineal side incision of perinatal delivery on the parturient incision. Methods  A total of 60 primipara with perineal side incision from April 2018 to April 2019 were selected and divided into two groups according to the random number table method. The control group of 30 cases received perineal side incision subcutaneous cosmetic suture combined with routine nursing cooperation. The observation group 30 cases were combined with comprehensive nursing intervention during the perioperative period. The total duration of labor， the perineal pain at 48 hours postpartum， and the healing time of the incision were compared between the two groups. The reaction of the nodules within 4 weeks after delivery was recorded in the two groups， at 3 and 6 months after operation. The Vancouver scar scale（VSS） and the Patient scar assessment scale（PSAS） were used to evaluate the beauty of the side incision. Results  The total stage of labor and perineal pain 48 hours after delivery in the observation group were better than those in the control group， and the differences were statistically significant（P<0.05）. The primary healing rate of perineal incision in the observation group was slightly higher than that in the control group， and there was no significant difference between the two groups（P>0.05）. Within 4 weeks postpartum， the incidence of suture reaction in the observation group was significantly lower than that in the control group（P<0.05）. At 3 and 6 months after delivery， the scores of VSS and PSAS in the observation group were significantly lower than those in the control group（P<0.05）. Conclusion  Perineal lateral incision and subcutaneous cosmetic suture combined with comprehensive nursing of the perineal side of the labor delivery can effectively shorten the birth time of the primipara and relieve the postpartum pain. The incision heals quickly， and the appearance and safety are high.

Key words： comprehensive nursing; primipara; perineal lateral incision and subcutaneous cosmetic suture; natural labor; beauty; scar

会阴切开是阴道分娩中用于防止会阴、盆底组织严重裂伤，缓解盆底组织对胎儿头部压迫，加速胎儿娩出的一种手段。会阴侧切能够有效降低产妇并发症发生情况，但手术创口愈合后的瘢痕无法满足爱美人士的要求，因此会阴切口缝合方式的选择非常重要[1]。会阴侧切皮下美容缝合术相较于传统分层缝合法具有切口皮肤美观度高、疼痛程度较轻等优势，因此被广泛应用于初产妇阴道分娩助产过程中[2]。但女性阴部分泌物较多易诱发切口感染，再加上疼痛应激造成的线结反应[3]，故针对会阴侧切初产妇制定科学的护理方案非常关键。……