折叠缝合法预防子宫下段瘢痕薄弱处切口憩室的效果  

Effect of Plicating Suture in Preventing Incision Diverticulum at Weak Area of Lower Uterine Scar

作　　者：程吉红 何丽艳 刘芬 CHENG Jihong;HE Liyan;LIU Fen(Department of Obstetrics and Gynecology,Dexing People's Hospital,Dexing 334200,China;不详)

机构地区：[1]德兴市人民医院妇产科,江西德兴334200

出　　处：《中国医学创新》2024年第26期132-136,共5页Medical Innovation of China

基　　金：上饶市指导性科技计划项目(2023CZDX231)。

摘　　要：目的:探究因多次剖宫产所致的瘢痕子宫产妇子宫下段瘢痕薄弱处采取折叠缝合法对预防子宫切口憩室的影响。方法:选取德兴市人民医院2023年1—12月因多次剖宫产所致的瘢痕子宫产妇80例,以随机数字表法分为对照组与观察组,每组40例。对照组采用传统的连续单纯双层缝合技术进行处理,观察组在对照组基础上对子宫下段的瘢痕薄弱区域引入折叠缝合法进行加强处理。观察两组手术情况,比较两组子宫切口愈合情况及C反应蛋白(CRP)。结果:观察组手术时间、血性恶露持续时间、住院时间均短于对照组,肛门排气时间早于对照组,术后出血量少于对照组,差异均有统计学意义(P<0.05)。术后42 d,两组切口瘢痕憩室发生率比较,差异无统计学意义(P>0.05);术后42 d,观察组子宫下段肌层厚度优于对照组,差异有统计学意义(P<0.05)。术后3个月,观察组和对照组月经复潮各15例,差异无统计学意义(P>0.05)。术后3个月,观察组切口瘢痕憩室发生率低于对照组,差异有统计学意义(P<0.05);观察组子宫下段肌层厚度大于对照组,差异有统计学意义(P<0.05)。术后第3天,观察组CRP显著低于对照组,差异有统计学意义(P<0.05)。结论:针对多次剖宫产的瘢痕子宫,采用折叠缝合法对子宫下段薄弱部位进行修补能有效预防子宫切口憩室形成,可缩短手术时间,改善手术情况,且术后恢复快,能减轻炎症反应。Objective:To explore the effect of plicating suture at the weak area of lower uterine scar on preventing uterine incision diverticulum in puerpera with scarred uterus due to multiple cesarean section.Method:A total of eighty puerpera who had scarred uterus caused by multiple cesarean section and were admitted to Dexing People's Hospital from January to December 2023 were selected,and they were divided into a control group and an observation group by random number table method,with 40 cases in each group.The control group was treated with traditional continuous simple double-layer suture,while the observation group was treated with plicating suture at the weak area of the lower uterine scar as enhanced treatment on the basis of the control group.Surgical conditions were observed,uterine incision healing and C reactive protein(CRP)levels were compared between the two groups.Result:Surgical time,duration of bloody lochia and hospital stay of the observation group were shorter than those of the control group,anal exhaust time was earlier than that of control group,postoperative bleeding volume was less than that in the control group,the differences were statistically significant(P<0.05).42 days after surgery,there was no statistically significant difference in the incidence rate of incision diverticulum in two groups(P>0.05).42 days after surgery,thickness of the lower uterine muscle layer in the observation group was better than that in the control group,the difference was statistically significant(P<0.05).Three months after operation,15 cases of menorrhagia in the observation group and 15 cases in the control group,the difference was not statistically significant(P>0.05).Three months after surgery,the incidence rate of incision diverticulum in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05);the thickness of the lower uterine muscle layer in the observation group was greater than that in the control group,the difference was statistically significant

关 键 词：瘢痕子宫 多次剖宫产 折叠缝合法 子宫切口憩室 C反应蛋白 

分 类 号：R719.8[医药卫生—妇产科学]