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剖宫产横切口不同缝合法的临床应用比较 被引量:7

Comparison of Different Clinical Suturing Applications for Cesarean Transverse Incision
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摘要 目的:寻求美观、有效、实用的剖宫产横切口皮肤缝合处理方法。方法:对820例剖腹产横切口分别采用4种皮肤缝合处理方式:(1)4/0薇乔可吸收缝线间断缝合脂肪层再以鼠齿钳钳夹皮肤5min(A组,300例);(2)4/0薇乔可吸收缝线皮内连续缝合(B组,300例);(3)4/0薇乔可吸收缝线间断缝合脂肪再以胜康医用胶粘合皮肤(C组,120例);(4)传统丝线间断褥式缝合皮肤全层3~5针(D组。100例)。比较4种缝合方式的愈合效果。结果:四组比较:切口甲级愈合率无显著性差别(P〉0.05)。伤口化脓仅在D组出现。其发生率为1.00%;缝线反应A、B、C组与D组比较,P〈0.01,差别有显著性;脂肪液化D组分别与A、B、C组比较,P〈0.05,差异均有显著性;皮肤对合D组分别与A、B、C组比较,P〈0.05,差异均有显著性;经济比对C组价格最高,A、B组次之,D组最低。结论:4/0薇乔可吸收缝线间断缝合脂肪层再以鼠齿钳钳夹皮肤5min可达到保持患者肌肤完美性的要求.且减轻术后痛苦及缝线等不良反应.易为患者接受.具有较好的社会效益及经济效益. Objective: To seek effective and practical suturing methods for cesarean transverse incision. Methods: Four skin-suturing methods were applied to 820 cases of cesarean transverse incision which were grouped A, B, C and D: (1) applying 4/0 vicryl absorbable interrupted suture to fat layer plus 5-minute skin tightening with Auis clamp (group A, n=300); (2) applying 4/0 vieryl absorbable intradermic suture continuously (group B, n=300); (3) applying 4/0 vicryl absorbable interrupted suture plus Shengkang medical glue (group C, n=120); (4) applying traditional mattress stitching method with silk threads, 3~5 stitches for full-thickness skin suturing (D group, n=100). The healing effects of the four skin-suturing methods were closely observed and compared. Results: Comparing the healing effects of the four skin suturing methods, there was no significant difference in class A healing rates of incision (P〉0.05). Only group D wituessted festering wounds (incidence 1.00%). Suture reactions among group A, B, C and D wimessted significant difference (P〈0.01). Compared with group A, B and C, fat liquefaction observed in group D showed significant difference from all the other three groups (P〈 0.05). Group D also showed significant difference in skin involution from the other three groups (P〈0.05). In terms of costs incurred, group C was the highest, followed by group A and B; group D incurred lowest costs. Conclusion: 4/0 vicryl absorbable interrupted suture combining 5-minute skin tightening with Allis clamp is better than the other three suturing methods in skin healing effect, postoperative adverse reactions, pain relief, costs and other benefits.
出处 《实用中西医结合临床》 2014年第5期11-12,共2页 Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine
关键词 剖宫产 横切口皮肤缝合处理方式 临床应用 Cesarean transverse incision Skin suturing methods Clinical application
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参考文献2

  • 1Zhang J,Liu YH,Meikle S,et al.Cesarean delivery on maternal request in Southeast China[J].Obstet Gynecol,2008,111(5): 1 077-1 082. 被引量:1
  • 2郑怀美,田顗主编..妇产科手术失误及处理[M].昆明:云南科学技术出版社,1998:274.

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