减张缝合在产后会阴裂伤中的临床研究  

Clinical study on tension-reduced suture in postpartum perineal laceration

作　　者：周平[1] 王晓霜[2] 肖杨洋 郝娜[3] 刘大纯 ZHOU Ping;WANG Xiaoshuang;XIAO Yangyang;HAO Na;LIU Dachun(Department of Nursing, Chongqing Municipal Hospital of Traditional Chinese Medicine,Chongqing 400011,China;Department of Obstetrics and Gynecology, Chongqing Municipal Hospital of Traditional Chinese Medicine,Chongqing 400011,China;Departent of Orthopaedics, Chongqing Municipal Hospital of Traditional Chinese Medicine,Chongqing 400011,China)

机构地区：[1]重庆市中医院护理部,重庆400011 [2]重庆市中医院妇产科,重庆400011 [3]重庆市中医院骨科,重庆400011

出　　处：《重庆医学》2019年第11期1906-1908,1911,共4页Chongqing medicine

摘　　要：目的研究减张缝合对产后会阴裂伤愈合情况的影响。方法将经阴道分娩会阴裂伤深Ⅱ度及Ⅲ度产妇共计100例分为减张缝合组及传统缝合组,每组50例:减张缝合组产妇伤口采用减张缝合术缝合;传统缝合组产妇伤口采用常规缝合方式缝合。术后3d内每天观察红肿、硬结、感染情况;术后7d观察伤口愈合情况;术后42d行盆底功能采用表面肌电图评分评价盆底功能。结果减张缝合组甲级愈合率高于传统缝合组(94%vs.76%,P<0.05);3d内减张缝合组发生红肿、硬结发生率均低于传统缝合组,两组比较差异有统计学意义(12%vs.28%,8%vs.17%,P<0.05);两组感染的发生率比较差异无统计学意义(6%vs.16%,P>0.05);产后42d盆底功能评分减张缝合组高于传统缝合组,两组比较差异有统计学意义(53.52±8.82)分vs.(49.42±8.35)分,P<0.05:。结论减张缝合能有效促进深Ⅱ度及Ⅲ度会阴裂伤术后愈合,减少红肿及硬结发生率,改善盆底远期功能,提高产后生活质量,值得临床推广。Objective To study the influence of tension-reduced suture on postpartum perineal laceration healing. Methods One hundred cases of postpartum perineal laceration deep Ⅱ degree and Ⅲ degree after transvaginal delivery were divided into the tension-reduced suture group and traditional suture group,50 cases in each group.The parturients in the tension-reduced suture group adopted the tension-reduced suture;while those in the traditional suture group adopted the routine suture.Then the redness,swollen,induration and infection on postoperative 3 d were observed.The wound healing was observed on postoperative 7 d.The pelvic floor function evaluation on postoperative 42 d was performed by adopting the surface electromyography(sEMG). Results The first grade healing rate in the tension-reduced suture group was higher than that in the traditional suture group(94% vs .76 %, P <0.05);the concurrence rate of redness and induration within 3 d in the tension-reduced suture group were lower than those in the traditional suture group,the differences between the two groups were statistically different(12%% vs .28%,8% vs .17%, P <0.05);the infection occurrence rate had no statistical difference between the two groups(6% vs .16%, P >0.05);the pelvic floor functional score at postpartum 42 d in the tension-reduced suture group was higher than that in the traditional suture group,and the difference between the two groups was statistically significant(53.52±8.82)points vs .(49.42±8.35) points, P <0.05:. Conclusion The tension-reduced suture can effectively promote the healing of postpartum perineal laceration deep Ⅱ degree and Ⅲ degree,reduce the occurrence rate of redness and induration,improve the pelvic floor long- term function,increase the postpartum living quality and is worthy of clinical promotion.

关 键 词：减张缝合 会阴裂伤 并发症 盆底功能 

分 类 号：R473.71[医药卫生—护理学]