聚丙烯不可吸收线与可吸收线用于剖宫产皮肤切口缝合的临床效果比较

Comparison of the clinical effect of non-absorbable polypropylene thread and absorbable thread in suture of cesarean section skin incision

目的:探讨聚丙烯不可吸收线与可吸收线用于剖宫产皮肤切口缝合的临床效果。方法:2019年12月~2020年12月在本院进行剖宫产手术的120例产妇作为研究对象,根据皮肤切口缝合方案不同分为对照组60例(微桥可吸收缝线进行皮内连续水平褥式缝合)、观察组60例(采用聚丙烯不可吸收线进行皮内连连续水平褥式缝合)。比较2组临床指标、不同时间伤口愈合情况、术前及术后炎症指标水平,观察并发症总发生率。结果:(1)观察组拆线时间、住院天数、创面愈合时间均短于对照组,拆线时出现疼痛率及手术切口裂开率均低于对照组(P<0.05)。(2)随着手术时间的延长,2组术口红肿率、渗液率逐渐降低,瘢痕深度逐渐变浅,瘢痕宽度逐渐缩短(P<0.05);观察组术后1d、1周、6周术口红肿率、渗液率均低于对照组(P<0.05);观察组术后1d、1周、6周、3月、6月瘢痕深度逐渐变浅程度及瘢痕宽度逐渐缩短程度均大于对照组(P<0.05)。(3)与术前比较,术后1d、3d两组IL-1、IL-10、TNF-α水平均升高(P<0.05),但观察组术后1d、3d的IL-1、IL-10、TNF-α水平均低于对照组(P<0.05)。(4)对照组并发症总发生率13.33%显著高于观察组3.33%(P<0.05)。结论:在剖宫产皮肤切口缝合术中采用不可吸收的聚丙烯缝线安全性高、美观度好,能降低炎症指标水平,促进产妇预后。

Objective:To investigate the clinical effect of polypropylene non-absorbable thread and absorbable thread in suture of cesarean section skin incision.Methods:120 parturients who underwent cesarean section in our hospital from December 2019 to December 2020 were used as the research objects.According to the different suture schemes of skin incisions,they were divided into 60 cases in the control group(microbridge absorbable sutures for subcutaneous continuous level Mattress suture),60 cases in the observation group(using polypropylene non-absorbable thread for subcutaneous continuous horizontal mattress suture).The clinical indicators,wound healing at different times,preoperative and postoperative inflammation index levels of the two groups were compared,and the total incidence of complications were observed.Results:(1)The suture removal time,hospitalization days,and wound healing time of the observation group were shorter than those of the control group.The pain rate and surgical incision dehiscence rate during suture removal were lower than those of the control group(P<0.05).(2)With the prolongation of the operation time,the redness and swelling rate and fluid exudation rate of the two groups gradually decreased,the scar depth gradually became shallower,and the scar width gradually shortened(P<0.05);the redness and swelling rate,the exudation rate 1d,1 week,6 weeks after operation of the observation group were lower than those of the control group(P<0.05);the gradual shallowness of scar depth and the gradual shortening of scar width 1d,1 week,6 weeks,3 months,and 6 months after the operation of the observation group were all greater than those in the control group(P<0.05).(3)Compared with preoperatively,the levels of IL-1,IL-10 and TNF-αin the two groups increased on the 1st and 3rd day after operation(P<0.05),but the levels of IL-1 and IL-10 in the observation group increased on the 1st and 3rd day after operation.The level of TNF-αwas lower than that of the control group(P<0.05).(4)The total incidence of complications in the control group was 13.33%,which was significantly higher than that in the observation group(P<0.05).Conclusion:The use of non-absorbable polypropylene sutures in the suture of skin incisions in cesarean section has high safety and good aesthetics.It can reduce the level of inflammation indicators and promote the prognosis of the parturient.