何林娜 高麗

[摘要]目的：對(duì)比皮膚減張閉合器縫合與傳統(tǒng)縫合對(duì)剖宮產(chǎn)產(chǎn)婦切口美觀度以及瘢痕形成的影響。方法：納入筆者醫(yī)院2018年1月-2019年1月112例剖宮產(chǎn)產(chǎn)婦，采用隨機(jī)數(shù)字表法分為觀察組、對(duì)照組各56例，對(duì)照組產(chǎn)婦采用常規(guī)縫合方式，觀察組產(chǎn)婦應(yīng)用皮膚減張閉合器縫合。比較兩組產(chǎn)婦術(shù)后1周、術(shù)后1個(gè)月切口疼痛程度[視覺模擬評(píng)分法（Visual analogy score，VAS）]評(píng)分，切口愈合情況（創(chuàng)面閉合時(shí)間，術(shù)后2周甲級(jí)愈合率），術(shù)后3個(gè)月瘢痕遺留情況（瘢痕增生發(fā)生率、瘢痕厚度、瘢痕寬度）以及切口美觀程度評(píng)價(jià)。結(jié)果：觀察組術(shù)后1周、術(shù)后1個(gè)月VAS評(píng)分均低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;觀察組創(chuàng)面閉合時(shí)間小于對(duì)照組，術(shù)后2周切口甲級(jí)愈合率高于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）;術(shù)后3個(gè)月，觀察組瘢痕增生發(fā)生率低于對(duì)照組，瘢痕厚度、瘢痕寬度均小于對(duì)照組，觀察組切口美觀度高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：對(duì)比傳統(tǒng)縫合，皮膚減張閉合器縫合可有效改善術(shù)后切口疼痛，利于切口愈合，減少瘢痕形成，美觀度更高。

[關(guān)鍵詞]皮膚減張閉合器縫合;剖宮產(chǎn);切口愈合;美觀度;瘢痕

[中圖分類號(hào)]R622 ? ?[文獻(xiàn)標(biāo)志碼]A ? ?[文章編號(hào)]1008-6455（2020）05-0097-03

Abstract： Objective ?To compare the effects of skin reduction and closure suture and traditional suture on aesthetic degree and scar formation of puerperae with cesarean section. Methods ?112 cases of puerperae with cesarean section in our hospital from January 2018 to January 2019 were enrolled. They were divided into the observation group and the control group according to the random number table method， with 56 cases in each group. The control group was given traditional intermittent suture， and the observation group was treated with skin reduction and closure suture. The incision pain degree [visual analogue scale （VAS）] and wound healing （wound closure time， first wound healing rate at 2 weeks after surgery） at 1 week after surgery and at 1 month after surgery， scar residue （incidence rate of scar hyperplasia， thickness of scar， width of scar） and aesthetic degree evaluation of incision were compared between the two groups. Results ?The VAS scores of incision pain degree in the observation group were lower than those in control group at 1 week and 1 month after surgery， the differences were statistically significant （P<0.05）. The wound healing time in observation group was smaller than that in control group， and the first incision healing rate at 2 weeks after surgery was higher than that in control group （P<0.05）. At 3 months after surgery， the incidence rate of scar hyperplasia in observation group was lower than that in control group， and the scar thickness and scar width were smaller than those in control group （P<0.05）. And the incision aesthetic degree in observation group was higher than that in control group （P<0.05）. Conclusion ?Compared with traditional intermittent suture， skin reduction and closure suture can effectively improve postoperative incision pain， facilitate wound healing and reduce scar formation， with higher aesthetic degree.