改良8字形缝合术在腹腔镜下肌壁间子宫肌瘤剔除术中的应用

Application of a modified figure-of-eight suture in laparoscopic intramural myomectomy

目的探讨改良8字形缝合术在腹腔镜下肌壁间子宫肌瘤剔除术中应用的临床效果。方法2008年1月至2011年1月期间我院收治的80例肌壁间子宫肌瘤患者根据人院顺序单双号被均分为对照组和观察组。对照组术中采用常规双层间断法缝合肌层和浆膜层，观察组采用改进的8字形单层间断缝合法缝合浆肌层的同时包埋肌瘤包膜。比较两组患者手术时间、术中出血量、住院时间、术中剔除肌瘤的数量和平均直径。结果两组患者剔除的子宫肌瘤数量对照组（3．5±1．4）、观察组（3．6±1．3）；肌瘤平均直径对照组（4．6±1．9）cm、观察组（4．7±2．1cm）；两组比较差异无统计学意义（P〉0．05）。但观察组患者手术时间对照组（95．6±23．4）min、观察组（76．2±22．6）min；术中出血量对照组（105．6±34．8）ml、观察组（68．0±21．1）ml；术后3天外周静脉血血红蛋白含量下降值与术前相比，对照组（10．2±3．4）g，L、观察组（7．4±2．8）g／L；住院时间对照组（9．1±2．5）d、观察组（7．9±2．3）d，则明显低于对照组；两组比较差异有统计学意义（P〈0．05）。结论改良的8字形缝合术通过提高缝合速度，缩短手术时间，减少术中出血量，缩短住院时间，是一种高效的止血缝合方法。

Objective To evaluate the clinical effect of a modified figure-of-eight suture in laparoscopic intramural myomectomy. Methods From Jan 2008 to Jan 2011, 80 women with intramural myoma were recruited and divided into control group （n=40） and observation group （n=40） by odd or evennumber of their admission order. All patients received the same laparoscopie intramural myomectomy surgery and patients in control group were stanched and sutured with a conventional two-layer suture while patients in observation group were stanched and sutured with a modified figure-of-eight suture. The operation time, blood loss during surgery, hospital stays, and numbers and sizes of myoma removed were compared between the two groups. Results There were no statistical difference between the two groups in numbers of myoma removed [（3.5 ± 1.4） for control group vs. （3.6 ± 1.3） for observation group, P〉0.05] and diameters of myoma removed [（4.6 ± 1.9） cm for control group vs. （4.7 ± 2.1） cm for observation group, P〉0.05], while there were statistical differences between the two groups in operation time [（95.6 ± 23.4） min for control group vs. （76.2 ± 22.6） min for observation group, P〈0.05], blood loss during surgery [（105.6 ± 34.8） ml for control group vs. （68.0 ± 21.1） ml for observation group, P〈0.05], reduction of peripheral hemoglobin concentration on D3 of surgery [（10.2 ± 3.4） g/L for control group vs. （7.4 ± 2.8） g/L for observation group,P〈0.05] and hospital stays [（9.1 ±2.5） d for control group vs. （7.9 ± 2.3） d for observation group, P〈0.05]. Conclusion The modified figure-of-eight suture can reduce the operation time, blood loss and hospital stays. It is an efficient suture method.