腹腔镜下卵巢皮内荷包缝合与表面贯穿缝合两组不同的缝合方法的对比研究

Comparative study of two different operation suture methods: ovary cortex purse-string suture and ovary cortex penetrating suture

目的比较腹腔镜卵巢囊肿剥除手术中两种不同缝合止血方式的应用价值。方法选取2013年1月至2015年12月期间茂名市人民医院妇科行腹腔镜下单侧卵巢良性肿瘤剥除术的患者80例,将其分为两组:A组用0/4微乔小针细线卵巢皮质内荷包缝合式40例,B组用0/3微乔大针粗线贯穿缝合卵巢皮质40例,持续观察两组患者手术时间、术中出血量、手术前后激素水平、月经异常发生率和术后6个月的妊娠率。结果 (1)A组较B组手术时间短,出血量少,差异有统计学意义(P<0.05);(2)A组和B组卵巢功能检测结果均处于正常范围之内;(3)两组患者中有小部分患者在术后3个月内出现月经异常,但均可自行恢复;(4)术后6个月,A组患者中有5人自然妊娠,B组患者中有1人自然妊娠。结论腹腔镜卵巢囊肿剥除术中,采用镜下小针小线皮内荷包缝合的方式和传统大针粗线贯穿缝合相比较,两者对卵巢功能的影响均在正常范围之内,前者对手术时间相对较短,但对手术技巧要求较高,后者手术时间相对较长,但手术技巧要求相对较低,两种方法均可用于卵巢缝合。

Objective To observe the application values of two different hemostatic suture methods ovary cortex purse-string suture and ovary cortex penetrating suture in laparoscopic ovarian cystectomy. Methods A total of 80 patients, who have been conducted the laparoscopic ovarian cystectomy in Maoming Peopled Hospital from January 2013 to December 2015, were divided into two groups randomly： Group A, in which 40 cases patients were conducted the ovary cortex purse-string suture by the use of 0/4 small VICRYL Plus absorbable suture; Group B, in which 40 cases patients were conducted the ovary cortex penetrating suture by the use of 0/3 big VICRYL Plus absorbable suture. The opreation time, intraoperative blood loss, preoperative and postoperative hormone levels, ncidences of abnormal menstruation and pregnancy rate 6 months after the operation of two groups were continuous observed. Results The operation time was shorter and the intraoperative blood loss was ess in Group A than those in group B, in which the differences had the statistical significance （P 〈0.05）; he ovarian function of two groups were in the normal range; Several patients in two groups had abnormal menstruation 3 months after the operation but recoverd themselves; There were 5 patients in Group A and 1 patient in Group B naturally pregnant 6 months after the operation. Conclusion The influences of ovary cortex purse-string suture and ovary cortex penetrating suture in laparoscopic ovarian cystectomyon ovarian function were both in the normal range. Ovaiy cortex purse-string suture method had shorter operation time but required a higher surgical techniques, ovaiy cortex penetrating suture method had longer operation time but required a lower surgical techniques, both suture methods could be applied in ovarian suture.