两种缝合技术对形成剖宫产子宫切口疤痕憩室的比较

A Comparative Study of the Result of Cesarean Scar Defect or Diverticulums(CSD) Dealed by Two Suture Techniques

目的比较全层缝合法(包括子宫内膜)与分层缝合法(不包括子宫内膜)对形成剖宫产术后子宫切口瘢痕处憩室的差异.方法选择2014年4月至2015年12月在东莞市太平医院及东莞市厚街医院进行产前检查、需要剖宫产分娩的初产妇200例,随机分为观察组和对照组,观察组100例,采用全层缝合法(包括子宫内膜),对照组100例,采用分层缝合法(不包括子宫内膜),比较2组手术后结果和随访结果.结果观察组和对照组分别完成手术100例,平均年龄分别为(25.5±3.2)岁、(26.2±4.2)岁,差异无统计学意义(P>0.05);手术后,总手术时间、术后吸收热、恶露天数、24 h出血量、产后血色素在2组中差异均无有统计学意义(P>0.05);术后9个月进行阴道彩超检查,观察组有94例进行检查,对照组有92例进行检查,2组形成子宫切口憩室分别占25.5%、40.2%,差异有统计学意义(P<0.05).结论在控制子宫切口憩室方面,全层缝合法(包括子宫内膜)优于分层缝合法(不包括子宫内膜),今后还需要综合其他因素进一步探讨子宫切口憩室形成原因.

Objective To compare full-thickness suture （including endometrial layer） and split-thickness suture （excluding endometrial layer） on the formation of cesarean scar defect or diverticulums. Methods Two hundred primiparas who received caesarean section in Taiping Hospital of Dongguan and Houjie Hospital of Dongguan during April 2014 and December 2014 were enrolled in this study. The primiparas were randomly divided into observation group of 100 cases with full-thickness suture （including endometrial） , and control group of 100 cases with split-thickness suture （excluding endometrial layer） , and the operation results and follow-up results were compared in the two groups. Results The average age of observation group was （25.5 ± 3.2） years and （26.2 ± 4.2） years in control group, with no significant difference between two groups （ P = 0.1865） , and were was no significant difference between two groups in operation duration, postoperative absorption heat, loehia days, 24 hours bleeding, postpartum hemoglobin （P 〉 0.05） .9 months later, 94 primiparas in observation group and 92 in control group were examined by transvaginal color Doppler ultrasound, Primiparas with CSD accounted for 25.5% in observation group, which was significantly lower than 40.2% in control group （P〈0.05） . Conclusions The fllll-thickness suture （including endometrial layer） may be superior to split-thickness suture （excluding endometrial layer） in terms of CSD, and other risk factors were to be integrated to further explore the causes of CDS in future studies.