倒刺可吸收缝线在腹腔镜下宫角妊娠切除术中的应用

Clinical evaluation of bidirectional absorbable self-retaining suture in laparoscopic surgery for uterine horn pregnancy

目的评价宫角妊娠的腹腔镜下子宫角楔形切除术中,采用新型自固定倒刺可吸收缝线(QUILLTMSRS)缝合宫角创面,在术中创面止血、预防持续性宫外孕中的临床疗效。方法回顾性分析该院2011年1月-2014年2月,行腹腔镜手术治疗并成功随访的宫角妊娠患者72例,均采用腹腔镜下患侧子宫角楔形切除术,随机分为对照组35例,子宫创面采用普通的1-0可吸收线缝合,而研究组37例采用倒刺可吸收线缝合宫角创面,观察两组手术时间、术中出血量、术后血β-HCG降至正常所需的天数、PEP发生率的差异。结果所有手术均在腹腔镜下顺利完成,研究组的手术时间、术中出血量、血β-HCG降至正常所需的天数,均显著低于对照组(P<0.001),且有效减低了持续性异位妊娠发生例数。结论新型倒刺可吸收缝线在腹腔镜下子宫角楔形切除术中的应用,明显缩短缝合时间,简化操作,并降低了手术难度,且能有效减少持续性异位妊娠发生例数。

[ Objective ] To evaluate clinical feasibility of the bidirectional absorbable self-retaining suture ma- terial in treatment of uterine horn pregnancy. [Methods] Between January 2011 and February 2014, 72 patients with cornual pregnancy received laparoscopic cornual resection. They were randomly divided into control group （35 cases） which received traditional absorbable suture material to close the wound, and study group （37 cases） which re- ceived self-retaining suture. Then the operative time, estimated intra-operative blood loss, the required days for [β- HCG decline to normal, the rate of persistent ectopic pregnancy were retrospectively analyzed. [ Results] Laparo- scopic surgery was performed successfully in all cases. However, the modified technique can gain better resuhs with shorter operative time, less blood loss, quicker decline ofβ-HCG and fewer cases of persistent disease compared with the control group （all P 〈0.001）. [Conclusion] The new suture material and modified technique demonstrated significant clinical value in ease the difficulty and better hemostasis, finally reduced the incidence of persistent ec- topic pregnancy.