腹部加压结合美容缝合对瘢痕体质产妇剖宫产术中切口愈合的影响

Effect of Abdominal Compression Combined with Cosmetic Suturing on the Healing of Incisions during Cesarean Section in Women with Scar Texture

目的探讨腹部加压结合美容缝合对瘢痕体质产妇剖宫产术中切口愈合的影响。方法选取2019年1月至2020年1月广东省肇庆市广宁县人民医院收治的属于瘢痕体质的产妇70例患者,分为观察组和对照组,各组35例。对照组予以传统妇产科腹部单纯间断缝合法进行缝合,从内到外缝合腹膜,筋膜,皮下脂肪层和皮肤层。皮下和筋膜用1号和7号丝线缝合。观察组予以美容缝合技术进行缝合并用腹部加压,选择褥式缝合方法将皮内组织连续缝合至对侧顶端,手术过程中医助对缝线进行牵拉确保切口整齐对合,在患者的子宫底部增加敷料,再用腹带加压包裹住伤口及敷料。观察两组临床疗效、手术情况、术后视觉模拟评分法(VAS评分)及瘢痕恢复情况的变化。结果术后,观察组总有效率为94.28%高于对照组的77.14%(P<0.05);观察组手术情况(缝合时间、切口愈合时间、住院时间)均短于对照组(P<0.05);两组VAS评分无明显差异(P>0.05);观察组瘢痕有效恢复率为88.57%明显高于对照组68.57%(P<0.05)。结论瘢痕体质产妇剖宫产患者使用腹部加压结合美容缝合术可提高瘢痕恢复效果,改善预后且不会术后疼痛。

Objective To investigate the effect of abdominal compression combined with cosmetic suture on the healing of incision during cesarean section in women with scar texture.Methods A total of 70 cases of pregnant women belonging to scar body admitted to Guangning County People’s Hospital from January 2019 to January 2020 were selected as the study subjects and divided into observation and control groups with 35 cases in each group.The control group was sutured by traditional obstetrics and gynaecology abdominal simple interrupted suture method,and peritoneal,fascial,subcutaneous adipose and skin layers were sutured from inside to outside.The subcutis and fascia were sutured with 1-and 7-gauge silk sutures.The observation group was sutured by cosmetic suture technique and pressurized with abdomen,bedding suture method was selected to continuously suture the intradermal tissues to the contralateral apical side,and during the surgical process,TCM helped to draw the sutures to ensure that the incision was neatly aligned,add dressings to the uterine fundus of the patient,and wrap the wound and dressings with abdominal band compression.The clinical efficacy,surgical situation,postoperative visual analog scale(VAS)score,and scar recovery of the two groups were observed.Results Postoperatively,the total effective rate of 94.28%in the observation group was higher than 77.14%in the control group(P<0.05),the surgical conditions(suture time,incision healing time,hospital stay)in the observation group were shorter than those in the control group(P<0.05),there was no significant difference in VAS scores between the two groups(P>0.05),and the effective recovery rate of scars in the observation group was 88.57%higher than that in the control group(P<0.05).Conclusion Scar composition the use of abdominal compression in combination with cosmetic suturing in women undergoing cesarean section improves scar recovery and outcomes without postoperative pain.