MBVMS与传统缝合对瘢痕子宫剖宫产患者切口愈合、VSS评分及美观度的影响  

Comparative study of MBVMS and traditional suture on incision healing,VSS scores and aesthetics in patients with scarred uterus undergoing cesarean section

作　　者：张娜[1] 张淼芳[1] 白梦箫 崔张霞 ZHANG Na;ZHANG Miaofang;BAI Mengxiao;CUI Zhangxia(Department of Obstetrics,The Second Affliated Hospital of Shaanxi University of Chinese Medicine,Xianyang Shaanxi 712000,China)

机构地区：[1]陕西中医药大学第二附属医院产科,陕西咸阳712000

出　　处：《中国妇产科临床杂志》2023年第3期254-257,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：陕西中医药大学科研基金项目(2016QN31)。

摘　　要：目的观察改良埋没垂直褥式缝合(MBVMS)与传统缝合对瘢痕子宫剖宫产患者切口愈合、温哥华瘢痕量表(VSS)评分及美观度的影响。方法纳入2017年9月至2022年4月陕西中医药大学第二附属医院产科96例瘢痕子宫二次剖宫产患者,采用非随机同期对照及患者自愿原则进行分组,观察组50例采用MBVMS缝合,对照组46例采用传统间断缝合。比较两组手术相关参数、切口不良反应、切口愈合质量、瘢痕情况和切口美观度。结果观察组手术时间、缝合时间长于对照组(P<0.05);观察组术后7 d切口周围炎症、脂肪液化、皮下硬结总发生率低于对照组(P<0.05);观察组术后3个月切口甲级愈合率高于对照组(P<0.05);两组原腹部瘢痕最大隆起高度、瘢痕最大宽度差异均无统计学意义(P>0.05),观察组术后3个月腹部瘢痕最大隆起高度、瘢痕最大宽度均小于对照组(P<0.05);两组术后1 d VSS柔软度、色泽、厚度、血管分布评分差异均无统计学意义(P>0.05),术后3个月各项评分均较术后1 d提高(P<0.05),但观察组低于对照组(P<0.05);观察组术后3个月切口美观度优良率高于对照组(P<0.05)。结论瘢痕子宫剖宫产患者应用MBVMS切口愈合效果优于传统间断缝合。Objective To compare the effects of modified buried vertical mattress suture(MBVMS)and traditional suture on incision healing in patients with scarred uterus undergoing cesarean section.Methods 96 patients with scarred uterus undergoing second cesarean section in Obstetrics Department of the Second Affiliated Hospital of Shaanxi University of Chinese Medicine from September 2017 to April 2022 were included.According to the nonrandomized concurrent control and voluntary principle,they were divided as the observation group(50 cases)given MBVMS suture,and the control group(46 cases)adopted traditional interrupted suture.The surgery-related parameters,incision adverse reactions,incision healing quality,scar conditions and incision aesthetics were compared between the two groups.Results The surgical time and suture time in the observation group were longer than those in the control group(P<0.05).The total incidence rate of peri-incision infammation,fat liquefaction and subcutaneous induration was lower in the observation group than the control group at 7 days after surgery(P<0.05).Compared with the control group,the grade A incision healing rate in the observation group was higher at 3 months after surgery(P<0.05).There were no statistical differences in the maximum height of abdominal scar bulge and the maximum scar width between the two groups(P>0.05),and the above two indicators in the observation group at 3 months after surgery were smaller than those in the control group(P<0.05).The differences in the scores of softness,color,thickness and blood vessel distribution of VSS were not statistically significant at 1day after surgery(P>0.05).The various scores at 3 months after surgery were all enhanced compared to 1 day after surgery(P<0.05),but the scores of the observation group were lower(P<0.05).The excellent and good rate of incision aesthetics at 3 months after surgery was higher(P<0.05).Conclusion MBVMS in cesarean section of patients with scarred uterus has better incision healing effects than traditional inte

关 键 词：改良埋没垂直褥式缝合 传统间断缝合 瘢痕子宫 剖宫产 温哥华瘢痕量表 美观度 

分 类 号：R719.8[医药卫生—妇产科学]