rb-bFGF联合改良皮内缝合对剖宫产切口恢复的美学效果影响  

Aesthetic Effect of rb-bFGF Combined with Modified Intradermal Suture on Cosmetic Effect of Incision Recovery in Cesarean Section

作　　者：江海湛[1] 许飞燕 刘芬 卢亘华[1] JIANG Haizhan;XU Feiyan;LIU Fen;LU Genhua(Department of Obstetrics and Gynecology,Maoming Maternal and Child Health Hospital,Maoming 525000,Guangdong,China)

机构地区：[1]茂名市妇幼保健院妇产科,广东茂名525000

出　　处：《中国美容医学》2022年第11期20-23,共4页Chinese Journal of Aesthetic Medicine

基　　金：广东省医学科学技术研究基金项目(编号:B2018301)。

摘　　要：目的:探讨重组牛碱性成纤维细胞生长因子(Recombinant bovine basic fibroblast growth factor,rb-bFGF)联合改良皮内缝合法对剖宫产切口愈合及瘢痕形成的影响。方法:选取2020年7月-2020年12月于笔者医院接受剖宫产的产妇116例进行研究,随机分为对照组与观察组,每组各58例。两组均采用改良皮内缝合法缝合切口,缝合后对照组给予剖宫产常规护理,观察组在对照组基础上采用rb-bFGF干预。对比两组术后切口愈合情况、血清指标、疼痛评分以及随访6个月时产妇瘢痕情况和外观满意度。结果:术后,两组均未出现丙级愈合,观察组切口愈合情况显著优于对照组,差异有统计学意义(P<0.05)。观察组术后24 h体温、白细胞计数、中性粒细胞占比及C反应蛋白水平均显著低于对照组,差异有统计学意义(P<0.05)。观察组肛门排气时间与对照组接近,组间比较差异无统计学意义(P>0.05);但观察组切口完全愈合时间、住院时间及产后24 h出血量均显著低于对照组,差异有统计学意义(P<0.05)。两组切口渗液、皮下硬结发生率比较差异无统计学意义(P>0.05);而观察组红肿发生率低于对照组,差异有统计学意义(P<0.05)。观察组术后5 d、42 d时视觉模拟评分(Visual analogue scale,VAS)均显著低于对照组,差异有统计学意义(P<0.05)。术后6个月,观察组瘢痕长度、瘢痕厚度、切口瘢痕增生率、瘙痒发生率、疼痛发生率及外观满意率均显著优于对照组,差异有统计学意义(P<0.05)。结论:rb-bFGF与改良皮内缝合法联合应用于剖宫产中,可显著提高切口愈合质量、减小瘢痕面积,且不良反应少,有很好的应用价值。Objective To study the effects of recombinant bovine basic fibroblast growth factor(rb-bFGF)combined with modified intradermal suture on incision healing and scar formation of cesarean section.Methods 116 puerperae who underwent cesarean section in the hospital between July 2020 and December 2020 were selected for the study,and were randomly divided into the control group and the observation group with 58 cases in each group.The two groups were treated with modified intradermal suture for incision suture,and the control group was given routine nursing of cesarean section after incision suture,and the observation group was given rb-bFGF intervention on the basis of the control group.Postoperative incision healing,serum monitoring,recovery and pain score and scar status and appearance satisfaction at 6 months of follow-up were compared between the two groups.Results After surgery,there was no grade C healing in both groups,and the wound healing in the observation group was significantly better than that in the control group,the difference was statistically significant(P<0.05).The body temperature 24 h after surgery and the leukocyte count,neutrophil ratio and C-reactive protein level on the second day after surgery in the observation group were significantly lower than those in the control group(P<0.05).The anal exhaust time in the observation group was close to that in the control group,and there was no significant difference between the groups(P>0.05).However,the time of complete wound healing,hospital stay and 24 h postpartum hemorrhage in the observation group were significantly lower than those in the control group(P<0.05).There were no significant difference in the incidence of incision exudation and subcutaneous induration between the two groups(P>0.05).The incidence of redness and swelling in the observation group was lower than that in the control group(P<0.05).The VAS score of the observation group were significantly lower than those of the control group at 5 d and 42 d after operation(P<0.05).Six months

关 键 词：剖宫产 切口愈合 瘢痕 改良皮内缝合法 重组牛碱性成纤维细胞生长因子 并发症 

分 类 号：R622[医药卫生—整形外科]