显微镜下Parks切口无线结连续缝合在小儿共同性斜视手术后临床观察

目的探究显微镜下Parks切口无线结连续缝合在小儿共同性斜视手术后的应用效果。方法选取2017年1月—2018年5月接受显微镜下Parks切口手术的共同性斜视患儿共68例(117只眼),通过随机数字表法,分为观察组34例(60只眼)和对照组34例(57只眼)。对照组患儿于术中接受有线结连续缝合方法缝合切口,观察组患儿术中接受无线结连续缝合方法缝合切口。比较2组患儿斜视度、治疗总有效率、术后1 d舒适度以及术后1 d、3 d、5 d、7 d视觉模拟评分(VAS),并统计2组患儿术后不良反应发生情况。结果(1)斜视度:2组患儿治疗后比较,差异无统计学意义(P>0.05)。(2)有效率:观察组治疗总有效率(97.06%)与对照组(94.12%)比较,差异无统计学意义(P>0.05)。(3)舒适度:观察组患儿术后1 d舒适度优的例数高于对照组,舒适度差的例数低于对照组,差异具有统计学意义(Х²=7.619,P=0.006)。(4)VAS评分:观察组患儿术后1 d、3 d VAS评分低于对照组,差异具有统计学意义(t_1d=3.847,t_3d=4.367,均P=0.000)。(5)不良反应:观察组不良反应发生率(3.33%)低于对照组(14.04%),差异有统计学意义(Х²=4.283,P=0.038)。结论显微镜下Parks切口无线结连续缝合可提高患儿术后舒适度,降低术后疼痛感,减少瘢痕形成,但在施术过程中需有更高要求的缝合技术操作,避免影响切口愈合。

Clinical observation of continuous Parks incision with knotless suture after concomitant strabismus operation in children under microscope

OBJECTIVE To explore the application effect of continuous Parks incision with knotless suture in children concomitant strabismus surgery under microscope.METHODS A total of 68 children(117 eyes)with concomitant strabismus who underwent Parks incision surgery under microscope from January 2017 to May 2018 were selected and divided into observation group(60 eyes)and control group(57 eyes)by random number table method.Each group was consisted of 34 cases.The patients in the control group received continuous suture with knot,while the patients in the observation group received continuous knotless suture.The total effective rate,degree of strabismus,postoperative comfort condition(one day after surgery),and visual analogue scale(VAS)of 1d,3d,5d and 7d after surgery,and postoperative adverse reactions of the two groups was compared.RESULTS(1)Degree of strabismus:There was no statistically significant difference between the two groups after treatment(P>0.05).(2)Effective rate:The total effective rate of treatment in the observation group(97.06%)and the control group(94.12%)were not statistically different(P>0.05).(3)Comfort:There were more excellent comfort cases in the observation group than the control group.The difference was statistically significant between two groups(Х²=7.619,P=0.006).(4)VAS scores:The VAS scores of children in the observation group were lower than those in the control group on the 1st and 3rd day after oper ation,the difference was statistically significant(t_1d=3.847,t_3d=4.367,all P=0.000).(5)Adverse reactions:The incidence of adverse reactions in the observation group(3.33%)was lower than that in the control group(14.04%),and the difference was statistically significant(Х²=4.283,P=0.038).CONCLUSIONS Continuous knotless suture of Parks incision under microscope could improve postoperative comfort,reduce postoperative pain and the rate of scar formation in children.However,higher suture technique would be needed during operation to avoid affecting wound healing.