改良30°会阴侧斜切对产妇切口愈合的影响

Effect of Improved 30° Perineal Incision on Maternal Wound Healing

目的观察不同会阴切开方式对减轻产妇伤口疼痛的临床效果。方法 300例足月临产拟经阴道分娩的初产妇随机分为2组。实验组150例行30°会阴侧斜切开术并行皮内包埋缝合术,对照组150例采用传统的45°会阴侧斜切术,并行羊肠线及丝线缝合术。观察比较两组产妇产后24h伤口肿胀、疼痛、出血量、愈合以及产妇平均住院日。结果实验组阴道裂伤率32.38%,对照组阴道裂伤率58.22%,两组比较差异有统计学意义（χ^2=27.092,P〈0.01）,且实验组会阴切口出血量少、疼痛轻、住院日少,切口愈合好（u=-5.337、-5.257,t=7.360,u=-4.533,均P〈0.01）。结论改良式30°会阴侧斜切术角度小、组织薄、出血少,更符合组织解剖和生理结构。

Objective To evaluate the clinical effect of two types of episiotomies on alleviating maternal wound pain.Methods Three hundred full-term primiparas to give vaginal delivery in our hospital were randomly divided into two groups.The experimental group（150 cases） received 30° perineal incision and embedded suture.The control group（150 cases） received the traditional type of 45° perineal incision and catgut and silk suture.Postpartum 24-hour maternal wound swelling,pain,blood loss,wound healing and the average hospitalization length were compared.Results The rate of vaginal laceration was 32.38% in the experimental group and 58.22% in the control group,and the difference was significant（χ^2 =27.092,P〈0.01）.In the experimental group,the blood loss and pain were lower,the length of hospitalization was less and the incision healed better（u=-5.337,-5.257,t=7.360,u=-4.533,P〈0.01）.Conclusion In the improved 30° perineal incision,the angle is small,the tissue is thin,and the blood loss is reduced.This type of episiotomy accords better with the anatomical and physical structures.