缪铃　顾爱玲　钱艺美

[摘要]目的：探讨改良横切口美容缝合联合应用重组人表皮生长因子（Recombinant human epidermal growth factor，rhEGF）对剖宫产术后切口美观度和瘢痕形成的影响。方法：回顾性分析医院2019年1月-2020年6月收治的80例孕产妇的临床资料，其中采用改良横切口美容缝合（对照组）孕产妇40例，采用改良横切口美容縫合联合应用rhEGF（观察组）孕产妇40例。比较两组相关康复指标、术后并发症发生情况、瘢痕形成情况及切口美观度。结果：观察组切口完全愈合时间、住院时间均短于对照组，总并发症发生率低于对照组，差异均有统计学意义（P<0.05）。观察组瘢痕厚度、瘢痕长度、瘢痕宽度均小于对照组，差异有统计学意义（P<0.05）。观察组温哥华瘢痕评价量表（Vancouver scar scale，VSS）评分、患者瘢痕评价量表（Patient scar appraise scale，PSAS）评分、观测者瘢痕评价量表（Observer scar appraise scale，OSAS）评分均低于对照组，差异有统计学意义（P<0.05）。结论：剖宫产术中采用改良横切口美容缝合联合应用rhEGF可有效促进产妇切口愈合，减少并发症发生，减轻瘢痕形成程度，提高切口美观度。

[关键词]剖宫产;横切口;美容缝合;重组人表皮生长因子;美观度;瘢痕

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）09-0051-03

Effect of Modified Transverse Incision Cosmetic Suture Combined with Recombinant Human Epidermal Growth Factor On Incision Aesthetics and Scar Formation after Cesarean Section

MIAO Ling，GU Ai-ling，QIAN Yi-mei

（Department of Obstetrics and Gynecology，China People's Liberation Army Joint Service 904 Hospital，Wuxi 214000，Jiangsu，China）

Abstract： Objective  To explore the effect of modified transverse incision cosmetic suture combined with recombinant human epidermal growth factor（rhEGF） on incision aesthetics and scar formation after cesarean section. Methods  The clinical data of 80 cases of pregnant and lyingwomen admitted to the hospital from January 2019 to June 2020 were retrospectively analyzed. 40 cases of pregnant and lying-in women （the control group） were treated with improved transverse incision cosmetic suture. In the same period， 40 pregnant women with rhEGF （the observation group） were treated with improved cross incision cosmetic suture. The relevant rehabilitation indicators， postoperative complications， scar formation and incision aesthetics were compared between the two groups. Results  The time of complete wound healing and hospital stay in the observation group were shorter than those in the control group， the differences were statistically significant （P<0.05）. The incidence of total complications in the observation group was lower than that in the control group （P<0.05）. The scar thickness， scar length and scar width in the observation group were all smaller than those in the control group （P<0.05）. The scores of Vancouver scar scale （VSS）， Patient scar assessment scale （PSAS） and Observer scar assessment Scale （OSAS） in the observation group were all lower than those in the control group （P<0.05）. Conclusion  In cesarean section， modified transverse incision cosmetic suture combined with rhEGF can effectively promote incision healing in pregnant women， reduce the occurrence of complications， reduce the degree of scar formation， and improve the evaluation of incision aesthetics.

Key words： cesarean section; transverse incision; cosmetic suture; recombinant human epidermal growth factor; aesthetics; scar

腹部横切口是剖宫产手术常用的方式，采用腹带保护切口是过往剖宫产术后的常用手段，但相关研究发现[1-2]，使用腹带加压止血可导致术后出现切口脂肪液化、切口假愈合等问题，不利于产妇的恢复。剖宫产术后需要对切口进行缝合，但切口愈合后会遗留瘢痕，进而影响女性腹部美观度，因此美容缝合广受欢迎。传统美容缝合所使用的缝线易对皮肤组织产生压迫，术后易出现皮肤凹陷、组织萎缩等问题[3]。随着科技的不断发展，改良美容缝合因其切口隐蔽、创伤小等优点而成为了美容医学的关注点，该方法通过使用新型的生物医学材料、改良缝合方法等有效促进切口愈合[4]。虽然改良美容缝合在剖宫产手术中颇受欢迎，但是术后瘢痕组织形成的问题依然存在，亟需解决。……