负压封闭引流预防剖宫产术后切口愈合不良疗效观察

Observation on the Therapeutic Effect of Vacuum Sealing Drainage on the Prevention of Undesirable Incision Healing after Cesarean Section

目的对比观察负压封闭引流预防剖宫产术后切口愈合不良的临床疗效。方法将2015年1月—2016年12月威海市立医院收治的32例存在切口愈合不良高危因素的剖宫产患者随机分为试验组(16例)与对照组(16例),其中试验组患者采用负压封闭引流治疗剖宫产术后切口,对照组患者采用传统缝合换药治疗剖宫产术后切口。对比观察两组患者的切口感染、疼痛及愈合情况。结果治疗过程中,试验组患者中无1例出现切口感染,对照组患者中有3例出现切口感染,两组对比,P>0.05,差异无统计学意义。治疗7 d后,试验组患者切口均甲级愈合,对照组患者中切口甲级愈合者12例,两组对比,P<0.05,差异具有统计学意义。治疗过程中,试验组患者切口疼痛评分逐渐降低,而对照组患者切口疼痛评分呈先降低后升高的趋势,其中治疗第2天,两组患者切口疼痛评分对比,P均>0.05,差异无统计学意义;治疗第3、4、5、6、7天,两组患者切口疼痛评分对比,P均<0.01,差异具有统计学意义。结论负压封闭引流可有效缓解剖宫产术后切口疼痛,促进切口甲级愈合,预防切口愈合不良的发生,疗效显著,值得临床推广应用。

Objective To investigate the clinical efficacy of vacuum sealing drainage in preventing undesirable incision healing after cesarean section. Methods Thirty-two patients with high risks of undesirable incision healing after cesarean section,admitted to Burns and Plastic Surgery Department of Weihai Municipal Hospital between January 2015 and December 2016,were randomly divided into an experimental group（16 cases） and a control group（ 16 cases）. The patients in the experimental group were given vacuum sealing drainage to treat the incisional wound after caesarean section while the patients in the control group were given traditional suturing and dressing change. Incision infection,pain and healing condition in the two groups were observed and compared. Results During the course of treatment,none of the patients in the experimental group had incision infection,while 3 patients in the control group developed incision infection,between which the difference was not statistically significant（ P〈0. 05）. After 7 days of treatment,all patients in the experimental group realized class A healing while there were 12 patients in the control group with class A healing,between which the difference was statistically significant（ P〈0. 05）. After the treatment,incision pain scores in the experimental group gradually decreased,while the incision pain scores in the control group decreased firstly and then increased. On day 2 of treatment,the incision pain scores were compared between the two groups and the result showed no statistically significant difference（ P〈0. 05）. However,on respective day 3,4,5,6 and 7 of treatment,the incision pain scores were compared between the two groups and the results all showed statistically significant differences,all P〈0. 01. Conclusion Vacuum sealing drainage can effectively relieve the pain of incisional wound after cesarean section,promote the class A healing of incisional wound and prevent the occurrence of undesirable wound healing,deserving to be promoted in clinical practice.