Leroux Nathalie, Bujold Emmanuel
Department of Obstetrics & Gynecology, Hôpital Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.
Am J Obstet Gynecol. 2006 Jun;194(6):1585-90; discussion 1590. doi: 10.1016/j.ajog.2006.01.011. Epub 2006 Apr 21.
The goal of our study was to compare the impact of 3 suture materials on perineal pain and on resumption of sexual intercourse.
This randomized, controlled trial compared 3 types of suture materials (chromic catgut, polyglactin 910, fast-absorbing polyglactin 910) for second-degree perineal laceration or uncomplicated episiotomy. Patients were enrolled in early labor and assigned randomly to 1 of the 3 suture materials. Pain was evaluated at 48 hours, 6 weeks, and 3 months. The study subjects were questioned about residual perineal pain, resumption of sexual activity, and pain-free sexual intercourse. Logistic regression analyses were undertaken.
Of the 192 patients who were assigned randomly to groups, 66 patients had their perineal laceration repaired with chromic catgut; 60 patients had repair with polyglactin 910, and 66 patients had repair with fast-absorbing polyglactin 910. At 48 hours, there was no significant difference according to the pain measurement scores, but the median consumption of analgesics was significantly lower with fast-absorbing polyglactin 910 than with standard polyglactin 910. There was no difference in the resumption of sexual intercourse at 6 weeks after the delivery between chromic catgut (42%) compared with standard polyglactin 910 group (56%; P = .23). However, it was more frequent for women in the fast-absorbing polyglactin 910 group (66%; P = .02). After adjustment for confounding variables, perineal repair with fast-absorbing polyglactin 910 was associated with a higher rate of sexual intercourse (odds ratio, 2.55; 95% CI, 1.07-6.10) and a higher rate of pain-free sexual intercourse (odds ratio, 2.51; 95% CI, 1.03-6.10) at 6 weeks after delivery.
Fast-absorbing polyglactin 910 for perineal repair is associated with earlier resumption of sexual intercourse when compared with chromic catgut.
我们研究的目的是比较3种缝合材料对会阴疼痛和恢复性生活的影响。
这项随机对照试验比较了3种缝合材料（铬制肠线、聚乙醇酸910、速吸收聚乙醇酸910）用于二度会阴裂伤或无并发症的会阴切开术。患者在分娩早期入组，并随机分配至3种缝合材料中的一种。在48小时、6周和3个月时评估疼痛情况。对研究对象询问会阴残留疼痛、恢复性活动以及无痛性生活情况。进行逻辑回归分析。
在随机分组的192例患者中，66例患者用铬制肠线修复会阴裂伤；60例患者用聚乙醇酸910修复，66例患者用速吸收聚乙醇酸910修复。在48小时时，根据疼痛测量评分无显著差异，但速吸收聚乙醇酸910组的镇痛药中位消耗量显著低于标准聚乙醇酸910组。分娩后6周时，铬制肠线组（42%）与标准聚乙醇酸910组（56%；P = 0.23）恢复性生活情况无差异。然而，速吸收聚乙醇酸910组女性恢复性生活的频率更高（66%；P = 0.02）。在对混杂变量进行校正后，分娩后6周时，用速吸收聚乙醇酸910进行会阴修复与更高的性生活恢复率（优势比，2.55；95%可信区间，1.07 - 6.10）和更高的无痛性生活率（优势比，2.51；95%可信区间，1.03 - 6.10）相关。
与会阴裂伤缝合相比，用速吸收聚乙醇酸910进行会阴修复与更早恢复性生活相关。
