两种缝合技术对形成剖宫产术后子宫切口瘢痕处憩室的差异分析

Analysis of the Difference of Two Suture Techniques on the Formation of Diverticulum at the Scar of Uterine Incision After Cesarean Section

目的分析两种缝合技术对形成剖宫产术后子宫切口瘢痕处憩室的影响。方法在自愿的原则上,选择2019年1月-2020年5月该院收治的剖宫产患者56例作为研究对象,根据不同的缝合技术进行分组,对照组给予单层连续缝合技术,观察组给予双层连续缝合技术,记录两组患者的手术相关指标,实施为期1年的随访,观察患者子宫切口瘢痕处憩室的形成状况。结果观察组患者手术时间(29.02±2.63)min、术中出血量(191.01±31.09)mL、术后血性恶露持续时间(8.77±1.81)d、术后肛门排气时间(29.21±4.56)h、住院时间(7.58±1.79)d与对照组(28.49±2.67)min、(190.08±31.11)mL、(8.09±1.88)d、(29.27±4.68)h、(7.66±1.88)d相比,差异无统计学意义(t=0.748、0.112、1.379、0.049、0.163,P>0.05);观察组随访期间子宫切口瘢痕处憩室形成率、憩室残余子宫肌层厚度、憩室大小分别是7.14%(2/28)、(6.85±2.33)mm、(0.28±0.07)mL,较对照组数据28.57%(8/28)、(5.50±2.51)mm、(0.45±0.13)mL相比,差异有统计学意义(χ^(2)=4.383,t=2.086、6.093,P<0.05)。结论针对剖宫产患者,临床选择双层连续缝合技术有助于降低术后瘢痕处憩室的形成风险,加快伤口愈合。

Objective To analyze the influence of two suture techniques on the formation of diverticulum at the scar of uterine incision after cesarean section.Methods Based on the principle of voluntariness,56 cesarean section patients admitted to the hospital from January 2019 to May 2020 were selected as the research objects,grouped according to different suture techniques,and the control group was given a single-layer continuous suture technique;the observation group was given a double-layer continuous suture technique to record the operation-related indicators of the two groups of patients,and implement a one-year follow-up to observe the formation of the diverticulum at the scar of the uterine incision.Results Operation time(29.02±2.63)min,intraoperative blood loss(191.01±31.09)mL,postoperative bloody lochia duration(8.77±1.81)d,postoperative anal exhaust time(29.21±4.56)h,hospitalization time(7.58±1.79)d of observation group was compared with the control group(28.49±2.67)min,(190.08±31.11)mL,(8.09±1.88)d,(29.27±4.68)h,(7.66±1.88)d,the difference was not statistically significant(t=0.748,0.112,1.379,0.049,0.163,P>0.05);during the follow-up period of the observation group,the formation rate of diverticulum at the scar of uterine incision,the thickness of the residual myometrium of the diverticulum,and the size of the diverticulum were 7.14%(2/28),(6.85±2.33)mm,(0.28±0.07)mL,compared with the control group data of 28.57%(8/28),(5.50±2.51)mm,(0.45±0.13)mL,the difference was statistically significant(χ^(2)=4.383,t=2.086,6.093,P<0.05).Conclusion For patients with cesarean section,the clinical choice of double-layer continuous suture technique can help reduce the risk of diverticulum formation in scars and speed up wound healing.