叠式缝合在经阴道修复子宫瘢痕憩室中的应用

目的探讨叠式缝合在经阴道修复子宫瘢痕憩室的应用疗效.方法选取2014年3月至2019年6月因子宫瘢痕憩室行阴式手术的患者共97例进行研究,根据手术不同缝合方式分为观察组(45例)和对照组(52例),分别采用双层叠式缝合和双层连续缝合的技术,比较两组患者术中出血量、手术时间、术后最高体温、术后住院时间、术后子宫肌层厚度、术后月经天数、月经改善率及宫内妊娠率.结果术后子宫残余肌层厚度观察组(5.05±0.83)mm优于对照组(4.27±0.73)mm,早孕期流产率观察组0/14(0)低于对照组2/8(25.0)(P<0.05);两组患者术中出血量、手术时间、术后最高体温、术后住院时间、术后月经天数及月经改善率比较均无明显统计学差异(P<0.05).结论在阴式手术治疗子宫瘢痕憩室中采用双层叠式缝合可有效增加术后子宫肌层厚度、降低早孕期流产率,且不增加手术时间及围手术期并发症,值得在有妊娠意愿的患者中推广.

Objective To explore the effect of folding suture in transvaginal repair of cesarean scar diverticulum.Methods A total of 97 patients who underwent transvaginal surgery of cesarean scar diverticulum from March 2014 to June 2019 were prospectively studied.They were divided into experimental group(45 cases)and control group(52 cases)according to different suture methods.Double-layer folding suture and double-layer continuous suture were used to compare the intraoperative bleeding,operation time,postoperative maximum temperature,postoperative stay,postoperative myometrium thickness,postoperative menstrual days,menstrual improvement rate,and intrauterine pregnancy rate.Results The postoperative residual myometrium thickness in the experimental group(5.05±0.83)mm was beter than that in the control group(4.27±0.73)mm.The rate of miscarriage in early pregnancy in the experimental group was 0/14(0)lower than the control group 2/8(25.0).There were no statistically significant differences between the two groups in terms of intraoperative bleeding operation time,postoperative maximum temperature,postoperative stay,postoperative menstrual days and menstrual improvement rate.Conclusion The application of double-layer folding suture in transvaginal surgery for the treatment of cesarean scar diverticulum can effectively increase the myometrium thickness and reduce the rate of miscarriage in early pregnancy without increasing the operation time and perioperative complications.And thus,it is worth promoting among patients who are to conceive.