阴式全子宫切除术中骶主韧带不同缝线的对比研究

Comparison of different sutures for suturing the cardinal ligament and uterosacral ligament during transvaginal hysterectomy

目的：探讨阴式全子宫切除术中骶主韧带残端缝线对阴道残端愈合的影响。方法回顾分析阴式全子宫切除术并回访的病例140例，按时间段分为观察组和对照组各70例。对照组时间段为2010-01～2011-06，骶主韧带残端缝合的缝线用10号丝线。观察组时间段为2011-07～2013-01，骶主韧带残端缝合的缝线用7号丝线。术后1个月观察阴道排液，术后3个月观察阴道残端息肉（肉芽）、线头排异情况。结果对照组出院后阴道排液42例，其中阴道残端息肉（肉芽）、线头排异各22例；观察组出院后阴道排液7例，阴道残端息肉（肉芽）、线头排异各3例。两组比较差异有统计学意义（ P＜0.01）。结论阴式全子宫切除术术后残端愈合与骶主韧带缝合的缝线粗细有密切关系。

Objective To explore the effects of different sutures for suturing the stump of cardinal ligament and uterosacral ligament during transvaginal hysterectomy on vaginal stump healing .Methods A retrospective analy-sis was performed on the clinical data of 140 patients who received transvaginal hysterectomy .According to the time period,these patients were divided into observation group and control group with 70 cases in each group .The control group underwent the suturing of stump of cardinal ligament and uterosacral ligament with No 7 silk-sutures from Janu-ary 2010 to June 2011 .The observation group underwent the suturing of stumps of cardinal ligament and uterosacral ligament with No 10 silk sutures from July 2011 to January 2013 .The vaginal drainage at one month after surgery and vaginal stump′s polyps,granulation,thread rejection at three months after surgery were observed .Results After dis-charge, the control group showed vaginal drainage in 42 cases, of which the vaginal stump′s polyps granulation , thread rejection in 22 cases.After discharge observation group showed vaginal drainage in 7 cases,vaginal stump′s polyps granulation, thread rejection in 3 cases.There was significant difference between two groups （P〈0.01）.Con-clusion Between the vaginal stump healing after transvaginal hysterectomy and suture thickness for suturing stump of cardinal ligament and uterosacral ligament has a close relationship .