[摘要] 目的 探讨微清创定位缝合治疗产后会阴伤口愈合不良的临床效果。方法 选取2021年6月至2024年10月遵义医科大学附属医院收治的经阴道分娩后会阴伤口愈合不良（皮肤及肌肉深层裂开，累及肌层深度≥1cm）的106例产妇为研究对象。2021年6月至2022年12月53例产妇为对照组，采用传统期待疗法1∶5000高锰酸钾溶液浅坐浴治疗；2023年1月至2024年10月53例产妇为实验组，采用微清创定位缝合治疗。通过随访评价产妇的会阴伤口愈合时间、干预后7d伤口疼痛程度、干预后1个月伤口愈合情况及治愈率。结果 实验组产妇的会阴伤口愈合时间明显短于对照组；产妇干预后7d会阴伤口疼痛程度较对照组轻；干预后1个月伤口愈合情况优于对照组；治愈率高于对照组，差异均有统计学意义（Plt;0.05）。结论 采用微清创定位缝合治疗产后会阴伤口愈合不良可缩短会阴伤口愈合时间，减轻疼痛程度，伤口愈合情况良好，治愈率佳。

[关键词] 微清创；会阴；缝合；会阴伤口；愈合不良

[中图分类号] R713.4" """"[文献标识码] A """""[DOI] 10.3969/j.issn.1673-9701.2025.18.004

The application of micro-debridement positioning suture in poor perineal wound healing after delivery

MU Yongfang， HU Dan， ZHAO Maojing， CHEN Yangqin， ZHANG Yanyan

Department of Obstetrics， Affiliated Hospital of Zunyi Medical University， Zunyi 563000， Guizhou， China

[Abstract] Objective To investigate the clinical effect of micro-debridement and positioning suture in the treatment of poor perineal wound healing after delivery. Methods 106 pregnant women who were eligible for poor healing of perineal wounds （deep skin and muscle defragmentation， involving muscle layer depth ≥1cm） after vaginal delivery in Affiliated Hospital of Zunyi Medical University were selected as the research objects from June 2021 to October 2024. From June 2021 to December 2022， 53 cases in control group were treated with traditional anticipation therapy 1 ： 5000 potassium permanganate solution shallow sitz bath， and from January 2023 to October 2024， 53 cases in experimental group were treated with micro-debridement positioning suture. After the operation， follow-up was established with the pregnant women to evaluate the healing cycle of perineal wound， the degree of wound pain 7 days after the operation， the wound healing situation and the cure rate 1 month after the operation. Results The healing period of perineal wound in experimental group was shorter than that in control group; The degree of wound pain in experimental group was lower than that in control group 7 days after operation; The wound healing of one month after operation in experimental group was higher than that in control group; The effective rate of experimental group was higher than that of control group， the differences were statistically significant （Plt;0.05）. Conclusion The use of micro-debridement and positioning suture in the treatment of poor perineal wound can shorten the healing period of perineal wound， reduce the degree of wound pain， the wound healing is good， and the treatment efficiency is good.

[Key words] Micro-debridement; Perineum; Suture; Perineal wound; Poor healing

85%的经阴道分娩产妇可发生不同程度的会阴损伤，有活动性出血者需通过缝合修复达到止血、恢复原有解剖结构的目的。缝合后伤口愈合不良率为4.2%，裂开率为11.63%，多数情况感染与裂开并存^[1-2]。伤口裂开深度≤1cm时，传统期待疗法如中药外敷、高锰酸钾坐浴、红外线照射等可取得较好疗效^[3-4]。伤口裂开深度gt;1cm时，采用期待疗法疗程较长，带给产妇长时间痛苦的同时可出现愈合后瘢痕挛缩或组织缺失，严重影响产妇生活质量^[5]。……