子宫下段螺旋式同心圆缝合术在前置胎盘(并植入)手术中的应用

Application of Spiral Concentric Circle Suture of the Lower Uterine Seg⁃ment in the Surgery of Placenta Praevia(with Implantation)

目的探讨前置胎盘(并植入)产妇手术治疗期间以子宫下段螺旋式同心圆缝合术方式缝合的效果与价值。方法选取2021年1月—2023年6月新沂市人民医院进行前置胎盘(并植入)手术治疗的产妇80例为研究对象,按照随机抽签方式分组,对照组(40例)以子宫下段常规方式缝合术治疗;观察组(40例)以子宫下段螺旋式同心圆缝合术治疗;记录两组产妇围手术期相关指标,同时监测两组产妇术后不同时间出血量,比较两组之间差异。对两组产妇术前、术后3 d凝血功能指标予以检测,对比差异性。观察两组产妇术后出现的并发症,统计比较总发生概率。结果围手术期指标中,观察组手术所用时长(65.58±5.11)min、术后产妇恶露持续时长(15.22±2.01)d、住院总时长(5.41±1.01)d均短于对照组,差异有统计学意义(t=13.381、14.907、11.544,P<0.05),同时术中及术后产妇出血量均低于对照组,差异有统计学意义(P<0.05)。术后观察组产妇凝血指标测定结果均高于对照组,差异有统计学意义(P<0.05)。同时,观察组术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论临床开展前置胎盘(并植入)手术治疗期间采取子宫下段螺旋式同心圆缝合术配合可减少产妇术后出血量,促进切口愈合,同时减少并发症发生率。

Objective To explore the effect and value of spiral concentric circle suture of lower uterine segment during surgical treatment of parturients with placenta praevia(with implantation).Methods 80 parturients who underwent sur⁃gical treatment for placenta praevia(with implantation)in Xinyi People's Hospital from January 2021 to June 2023 were randomly drawn into groups.The control group(40 cases)was treated with suture of lower uterine segment in con⁃ventional way,and the observation group(40 cases)was treated with spiral concentric circle suture of lower uterine segment.The perioperative related indexes of the two groups of parturients were recorded,and the amount of postop⁃erative bleeding at different times of the two groups was also monitored to compare the statistical significance between the groups.The coagulation function indexes of the two groups were tested at 3 days before and after the operation,and the differences were compared.Observe the postoperative complications of the two groups of parturients and statis⁃tically compare the total probability of occurrence.Results In the perioperative period,the length of surgery in the ob⁃servation group(65.58±5.11)min,the duration of postoperative menstrual discharge(15.22±2.01)d,and the total length of hospitalization(5.41±1.01)d were shorter than those in the control group,and the differences were statisti⁃cally significant(t=13.381,14.907,11.544,P<0.05).Meanwhile,intraoperative and postoperative bleeding of parturi⁃ents were lower than that of the control group,and the differences were statistically significant(P<0.05).Postoperative coagulation indexes of parturients in the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Meanwhile,the total incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The use of spiral concentric circle suture of the lower uterine segment during the surgical treatment of pla⁃centa praevia(with implantation)can reduce the amount of postoperative bleeding,promote the healing of the incision,and reduce the incidence of complications.