不同缝合方法对初次分娩会阴自然裂伤的临床效果及安全性影响研究  

Clinical effect and safety of different suture methods on natural laceration of perineum during the first delivery

作　　者：张耀飞 陈春来 沈燕华 郑燕飞 ZHANG Yaofei;CHEN Chunlai;SHEN Yanhua;ZHENG Yanfei(Operating Room,Lishui Maternal and Child Health Hospital,Lishui 323000,Zhejiang,China;Department of Obstetrics,Lishui Maternity and Child Health Hospital,Lishui 323000,Zhejiang,China;Delivery Room,Lishui Maternal and Child Health Hospital,Lishui 323000,Zhejiang,China)

机构地区：[1]丽水市妇幼保健院手术室,浙江丽水323000 [2]丽水市妇幼保健院产科,浙江丽水323000 [3]丽水市妇幼保健院分娩室,浙江丽水323000

出　　处：《中国性科学》2021年第8期59-62,共4页Chinese Journal of Human Sexuality

基　　金：江苏省卫生计生委2015年度面上科研课题(H201536)。

摘　　要：目的分析不同缝合方法对初次分娩会阴自然裂伤的临床效果及安全性影响研究。方法选取2018年7月至2020年3月丽水市妇幼保健院诊治的108例初次分娩会阴自然裂伤产妇作为研究对象。随机分为A组和B组,各54例。在缝合方法的选择方面,A组采取传统皮内连续缝合法,B组采取减张缝合法。记录两组缝合时间、伤口出血量、下床活动时间、疼痛程度、愈合等级,观察两组产后3d内线头反应、瘢痕触痛、硬结形成和感染情况,随访42d,比较两组盆底功能障碍性表现。结果两组缝合时间、伤口出血量比较,差异无统计学意义(P>0.05);B组下床活动时间短于A组,差异具有统计学意义(P<0.05);B组切口疼痛程度小于A组,差异具有统计学意义(P<0.05);B组伤口愈合等级优于A组,差异具有统计学意义(P<0.05);两组线头反应和感染发生率比较,差异无统计学意义(P>0.05);B组瘢痕触痛和硬结形成发生率均低于A组,差异具有统计学意义(P<0.05)。随访后,两组压力性尿失禁和排尿困难发生率比较,差异无统计学意义(P>0.05);B组会阴伤口疼痛发生率低于A组,差异具有统计学意义(P<0.05)。结论减张缝合法对初次分娩会阴自然裂伤的解剖复位效果优于传统皮内连续缝合法,前者在减轻疼痛、促进愈合和减少不良影响上具有优势,值得临床予以重视。Objective To analyze the clinical effect and safety of different suture methods on natural laceration of perineum during the first delivery.Methods 108 cases of women with natural laceration of perineum during the first delivery in Lishui Maternal and Child Health Hospital from July 2018 to March 2020 were selected as study subjects,and randomly divided into group A and Group B,54 cases each.Group A adopted the traditional intradermal continuous suture method,while group B adopted the tension reduction suture method.Suture time,amount of wound bleeding,time of getting out of bed,length of hospital stay,pain degree,and healing grade were recorded.Intraoperative thrum reaction,scar tenderness,induration and infection within 3 days after delivery were observed.The two groups were followed up for 42 days to compare the functional disorders of the pelvic floor.Results There was no significant difference in suture time and wound bleeding between the two groups(P>0.05),the time of getting out of bed in group B was shorter than that in group A(P<0.05).The degree of incision pain in group B was lower than that in group A(P<0.05).The grade of wound healing in group B was better than that in group A(P<0.05).There was no significant difference in the incidence of thrum reaction and infection incidence between the two groups(P>0.05);The incidence of scar tenderness and induration in group B was lower than that in group A(P<0.05).The two groups of women were followed up,and there was no statistically significant difference in the incidence of stress incontinence and dysuria(P>0.05).The incidence of perineal wound pain in group B was lower than that in group A(P<0.05).Conclusions The tension reduction suture method is superior to the traditional intradermal continuous suture method in the anatomical reduction of natural laceration of the perineum during the first delivery,the former method has advantages in reducing pain,promoting healing and reducing adverse effects,and is worthy of clinical attention.

关 键 词：初次分娩 会阴自然裂伤 缝合方法 传统皮内连续缝合法 减张缝合法 

分 类 号：R714[医药卫生—妇产科学]