剖宫产术切口两种缝合法的对比分析.DOCVIP

临床医学论文-剖宫产术切口两种缝合法的对比分析 ???????????? 作者：魏晓红，干霞，刘合年，安虹，吴勤 ［摘 要］ 目的? 改进剖宫产切口的缝合技术。 方法? 将100例产妇随机分为两组，其中50例采用快薇乔可吸收线皮内连续缝合手术切口（观察组），50例采用三针间断褥式缝合手术切口（对照组）。比较两组住院时间及术后伤口愈合情况。 结果? 切口缝合时间观察组与对照组相比明显延长，但平均住院时间明显短于对照组，观察组甲级愈合率明显高于对照组，且愈合后皮肤较对照组平整，呈一条淡红色细线状瘢痕，皮下无硬结。 结论? 快薇乔可吸收线皮内连续缝合较三针间断褥式缝合效果好，值得推广。?????? 　　［关键词］ 剖宫产术;快薇乔;皮内连续缝合;间断褥式缝合???? 　　Comparison of two suture methods for incision of cesarean section????? 　　Abstract:Objective To improve the suturing techniques in the incisions of cesarean section.Methods A total of100cases of cesarean section were divided randomly into control and observation groups.Running intradermic suture with Vioryl sutures and interrupted mattress suture of three positions were employed in the observation and control groups，respectively.Length of stay and wound healing in the two groups were com-pared.Results The time for skin suture was markedly longer but length of stay was obviously shorter and the first healing rate was markedly higher in the observation group than that in the control group.In the observation group，all the patients had no subcutaneous nodules;the healing scars of the incision were thin and linear;and the skin was flat.Conclusion The results indicate that running intradermic suture with Vioryl sutures is bet-ter than interrupted mattress suture，which is worth being popularized in the incisions of cesarean section.????? 　　Keywords:cesarean section;Vioryl suture;running intradermic suture;interrupted mattress suture?????? 　　随着社会的不断进步，人们生活水平日益提高，手术患者对术后伤口的愈合也有了更高的要求，如术后伤口愈合快、疤痕小、住院时间短等。腹部切口缝合是外科的基本操作之一，尤其是孕妇下腹部脂肪层很厚，术后易出现液化，如何能在保证手术切口良好愈合的同时减少瘢痕，缝合的技术和方法十分重要。对此，我们将目前临床使用较广的三大针间断褥式缝合与可吸收快薇乔线皮内连续缝合进行了初步对比分析。???? 　　1 资料与方法 　　1.1 一般资料?????? 　　将100例有剖宫产手术指征，无下腹部手术史的产妇，随机分为两组，年龄为21～32岁。其中50例采用快薇乔可吸收线（强生公司）皮内连续缝合手术切口（观察组），50例采用三大针间断褥式全层缝合手术切口（对照组）。手术医生均为同组医生。???? 　　1.2 麻醉?????? 　　两组均采用连续硬膜外麻醉。???? 　　1.3 手术方法?????? 　　采用新式横切口剖宫产术［1］ ，手术完毕后，两组产妇切口均常规缝合至筋膜层。观察组:不缝合脂肪层，皮内缝合法是用3.0快薇乔从切口内一侧顶端皮肤真皮层开始刺入，缝针从皮肤的真皮层但未达到脂肪层