子宫颈缝合成形术与Sturmdorf缝合法在高级别鳞状上皮内病变子宫颈锥切术中应用效果比较研究  

Analysis of the application of modified cervical suture plasty and Sturmdorf suture in the operation of high-grade squamous intraepithelial lesions

作　　者：何剑颖 沈婷 寿坚 HE Jian-ying;SHEN Ting;SHOU Jian(Xiaoshan Hospital Affiliated Hang zhou Normal University,Hangzhou 311200,China)

机构地区：[1]杭州师范大学附属萧山医院,浙江杭州311200

出　　处：《中国实用妇科与产科杂志》2024年第7期762-764,共3页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：浙江省医药卫生科技计划项目(2023KY1013)。

摘　　要：目的 探讨子宫颈缝合成形术与Sturmdorf缝合法在高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)子宫颈锥切术中应用的效果。方法 选取2021年1月至2023年1月在杭州师范大学附属萧山医院行子宫颈锥切术治疗的87例HSIL患者作为研究对象,根据缝合方式不同分为子宫颈缝合成形术组(研究组,44例)和Sturmdorf缝合法组(对照组,43例),收集两组患者围手术期各项资料,比较两组患者术中及术后24 h出血量、术后应激反应指标(去甲肾上腺素、醛固酮、血管紧张素Ⅱ)的表达、术后3个月子宫颈塑形满意度及并发症发生情况。结果 (1)研究组患者术中及术后24 h出血量与对照组患者相比更低[分别为(18.68±5.26)mL vs.(13.54±4.73)mL和(21.57±4.68)mL vs.(10.35±4.65)mL,均P<0.001]。(2)研究组患者术后去甲肾上腺素、醛固酮、血管紧张素Ⅱ表达较对照组患者更低[分别为:(121.73±10.68)μg/L vs.(100.21±10.57)μg/L、(121.41±15.47)μg/L vs.(84.72±10.69)μg/L、(54.21±7.51)μg/L vs.(31.54±5.97)μg/L,均P<0.001]。(3)研究组患者术后3个月子宫颈塑形满意度较对照组患者更高(88.64%vs. 74.42%,P<0.05)。(4)研究组患者并发症总发生率与对照组患者相比更低(6.82%vs. 18.60%,P<0.05)。结论 对行子宫颈锥切术治疗的HSIL患者使用子宫颈缝合成形术缝合能显著减少出血量,降低应激反应对机体造成的不必要损伤,子宫颈塑形良好,可作为HSIL患者手术缝合的首选方法。Objective Objective To compare the efficacy of modified cervical suture plasty versus Sturmdorf suture on stress response and cervical shaping in patients with highly squamous intraepithelial lesions(high-grade squamous intraepithelial lesion,HSIL).Methods A total of 87 patients with HSIL who underwent cervical conization in Xiaoshan Hospital Affiliated to Hangzhou Normal University from January 2021 to January 2023 were selected as the study subjects,and were divided into modified cervical suture plasty group(study group,44 cases)and Sturmdorf suture group(control group,43 cases)according to different suture methods. Collecting the perioperative data of two groups,and comparing the intraoperative and 24-hour postoperative blood loss,the expression of postoperative stress response indexes(norepinephrine,aldosterone,angiotensin II),satisfaction with cervical shaping and the occurrence of complications at3 months after surgery between the two groups.Results(1)The intraoperative and 24-hour blood loss in the study group was lower than that in the control group[(18.68±5.26)mL vs.(13.54±4.73)mL and(21.57±4.68)mL vs.(10.35±4.65)mL,both P<0.001].(2)The expression of norepinephrine,aldosterone,and angiotensin II in the study group was lower than that in the control group[(121.73±10.68)μg/L vs.(100.21±10.57)μg/L,(121.41±15.47)μg/L vs.(84.72±10.69)μg/L,(54.21±7.51)μg/L vs.(31.54±5.97)μg/L,P<0.001].(3)Compared with the control group,the satisfaction of the patients in the study group was higher than that in the control group at 3 months after surgery(88.64% vs. 74.42%,P<0.05).(4)The total incidence of complications in the study group was lower than that in the control group(6.82% vs. 18.60%,P<0.05).Conclusion The use of modified cervical suture plasty in HSIL patients treated with cervical conization can significantly reduce the amount of bleeding,reduce unnec-essary damage to the body caused by stress response,and have good cervical conformation,which can be used as the preferred method of surgical suturing

关 键 词：子宫颈缝合成形术 子宫颈锥切术 出血量 子宫颈塑形 

分 类 号：R713.4[医药卫生—妇产科学]