宫颈冷刀锥切手术缝合方法探讨

Exploration of the operation skill and the way of suture of cervix on wound of cold knife conization

目的探讨宫颈冷刀锥切术中手术技巧及创面缝合方法的疗效。方法回顾分析2006年1月至2007年12月,北京中医药大学第三附属医院行宫颈冷刀锥切术52例,其中研究组32例采用缝扎双侧子宫动脉下行支+宫颈半荷包缝合成形法,对照组20例创面8字缝合,对比两组疗效。结果比较研究组和对照组,两组手术时间分别为(30±10)min、(25±15)min,(P>0.05)差异无统计学意义;两组术中出血量(50±46)ml和(65±35)ml、术后出血量(15±15)ml和(30±20)ml、术后住院天数(1.2±0.5)d和(1.8±0.5)d相比,差异均有统计学意义(P<0.05);两组均无复发、感染、宫颈狭窄、宫颈机能不全等并发症出现。结论锥切宫颈创面采用缝扎双侧子宫动脉下行支+宫颈创面半荷包缝合成形法,止血效果好,术后住院天数短。

Objective To explore the operation skills and the suture of cervical wound after cold knife conization.Methods We retrospectively reviewed 52 women who underwent cold knife conization from January 2006 to December 2007,including 32 as the study group with semi-pouch suture on the cervical wound and 20 as the control group with 8-shape suture.The effect,operative time,intraoperative and postoperative blood loss,postoperative hospital staying,polyp and complication rat were compared between the two groups.Results In the study group,the intraoperative blood loss [（50±46） ml vs.（65±35） ml],postoperative hospital staying[（1.2±0.5） d vs.（1.8±0.5） d],postoperative blood loss[（15±15） ml vs.（30±20） ml],postoperative polyp rate（3.12% vs.10%） were less than those of the control group,all P〈0.05.No significant difference was found of the operative time between the study and control group [（30±10） min vs.（25±15） min].No cervical stenosis,incompetence and other complication was found in the two groups.Conclusions The semi-pouch suture of the cervical wound after cold knife conization will not affect the therapeutic effect,and can achieve better hemostasis,shorten postoperative hospital staying and lower polyp rate.