改良宫颈缝合成形术在CINⅡ~Ⅲ宫颈锥形切除术后缝合中的应用  

Application of modified cervical suture plasty in suture after CIN Ⅱ-Ⅲ cervical conization resection

作　　者：李劲 王之珺 吴灵 巫湾 章君兰 代宁宁 LI Jin;WANG Zhi-jun;WU Ling;WU Wan;ZHANG Jun-lan;DAI Ning-ning(Department of Obstetrics and Gynecology,the 928th Hospital of PLA Joint Logistics Support Force,Haikou 571159,Hainan,CHINA)

机构地区：[1]中国人民解放军联勤保障部队第九二八医院妇产科,海南海口571159

出　　处：《海南医学》2022年第24期3214-3217,共4页Hainan Medical Journal

摘　　要：目的 探讨改良宫颈缝合成形术在宫颈上皮内瘤病变(CIN)Ⅱ~Ⅲ宫颈锥形切除术后缝合中的应用效果。方法 回顾性分析2017年1月至2022年1月于中国人民解放军联勤保障部队第九二八医院妇产科行宫颈锥形切除术的76例CINⅡ~Ⅲ患者的临床资料,依据缝合方式不同分组,其中42例采用改良宫颈缝合成形术者纳入研究组,34例采用Sturmdorf缝合法者纳入对照组。比较两组患者的手术时间、术中与术后出血量、锥底直径、锥高及随访3个月后的宫颈塑形满意度与并发症发生率。结果 研究组患者的手术时间、术中出血量、术后出血量、锥高分别为(22.04±6.11) min、(8.45±2.71) m L、(11.55±3.49) mL、(1.46±0.44) cm,明显短(低)于对照组的(27.06±8.67) min、(18.65±5.53) m L、(21.53±4.38) m L、(1.84±0.35) cm,差异均有统计学意义(P<0.05);术后,研究组患者的锥底直径为(1.81±0.49) cm,与对照组的(1.85±0.41) cm比较差异无统计学意义(P>0.05);随访3个月后,研究组患者的宫颈塑形满意度为95.24%,明显高于对照组的76.47%,差异有统计学意义(P<0.05);随访3个月后,研究组患者的并发症发生率为4.76%,明显低于对照组的26.47%,差异有统计学意义(P<0.05)。结论 改良宫颈缝合成形术应用于CINⅡ~Ⅲ宫颈锥形切除术后缝合中宫颈塑形好,且出血少,可作为CINⅡ~Ⅲ宫颈锥形切除术后缝合方式首选。Objective To investigate the application effect of modified cervical suture angioplasty in suture after cervical intraepithelial neoplasia(CIN) Ⅱ-Ⅲ cervical conization. Methods The clinical data of 76 CINⅡ-Ⅲ patients who underwent cervical conization in Department of Obstetrics and Gynecology, the 928thHospital of PLA Joint Logistic Support Force from January 2017 to January 2022 were retrospectively analyzed. According to different suture methods, 42 patients treated with modified cervical suture plasty were included in the study group, and 34 patients with Sturmdorf suture were included in the control group. The operation time, intraoperative and postoperative blood loss,cone bottom diameter, cone height, cervical shaping satisfaction, and complication rate after 3 months of follow-up were compared between the two groups. Results The operation time, intraoperative blood loss, postoperative blood loss, and cone height in the study group were(22.04±6.11) min,(8.45±2.71) m L,(11.55±3.49) m L, and(1.46±0.44) cm, which were significnatly shorter/lower than(27.06±8.67) min,(18.65±5.53) m L,(21.53±4.38) m L,(1.84±0.35) cm in the control group(P<0.05). After surgery, there was no significant difference in the diameter of cone bottom between(1.81±0.49) cm in the study group and(1.85±0.41) cm in the control group(P>0.05). After 3 months of follow-up, the satisfaction rate of cervical shaping in the study group was 95.24%, which was significantly higher than 76.47% in the control group(P<0.05). After 3 months of follow-up, the incidence of complications in the study group was 4.76%, which was significantly lower than 26.47% in the control group(P<0.05). Conclusion Modified cervical suture plasty has good cervical shaping and less bleeding in the suture after CIN Ⅱ-Ⅲ cervical conization. It can be used as the first choice for suture after CIN Ⅱ-Ⅲ cervical conization.

关 键 词：改良宫颈缝合成形术 宫颈锥形切除术 宫颈上皮内瘤病变 宫颈塑形 并发症 出血量 

分 类 号：R711.74[医药卫生—妇产科学]