阴道分娩会阴侧切术后伴阴道深部延裂的原因与改良缝合120例分析

Causes of Vaginal Deep Delayed Crack after Lateral Episiotomy and Modified Suture in Vaginal Delivery: An Analysis of 120 Cases

目的探讨阴道分娩会阴侧切术后伴阴道深部延裂的原因与改良缝合效果。方法选择珠海市金湾区三灶医院2006年1月至2012年12月阴道分娩会阴侧切术后伴阴道深部延裂120例产妇,用阴道拉钩充分暴露阴道伤口,将阴道黏膜层沿肌肉层裂伤方向剪开直至可清楚暴露裂伤顶端,结扎活动性出血点或破裂血管,然后用2个0可吸收线自裂伤顶端上方5 mm处开始全层间断缝合阴道壁,顶端8字缝合1针。结果裂伤的原因以医务人员因素及阴道炎为主,伤口甲级愈合率高达98.1%。结论改良缝合方法简单易行,是安全有效的缝合方法。

Objective To investigate the causes of vaginal deep delayed crack after lateral episiotomy and the efficacy of modified suture in vaginal delivery. Methods A total of 120 puerperae who underwent vaginal delivery in Jinwan District Sanzao Hospital of Zhuhai City between January 2006 and December 2012 and had vaginal deep delayed crack after lateral episiotomy were chosen in this study. Vaginal wound was exposed with vaginal retractor and vaginal mucosa was scissored along the direction of muscle layer laceration until the exposure of the top of the laceration. Active bleeding points or broken blood vessels were ligated, and then vaginal wall was sutured from the top of the laceration using absorbable interrupted sutures. A figure-of-eight suture was performed in the top. Results Medical personnel and vaginitis were the main causes of vaginal deep delayed crack. The rate of wound healing by first intention was 98.1%. Conclusion The modified suture is simple, safe and effective for vaginal deep delayed crack and is worthy of clinical promotion.