棒球缝合法对腹腔镜下巨大子宫肌瘤剔除术患者术后恢复情况的影响

Effect of baseball suture on postoperative recovery of patients undergoing laparoscopic myomectomy for giant uterine fibroids

目的研究棒球缝合法对腹腔镜下巨大子宫肌瘤剔除术患者术后恢复情况的影响。方法以回顾性分析为法,观察对象为2022年1月至2023年1月太原市中心医院收治入院的60例接受腹腔镜下巨大子宫肌瘤剔除术患者。根据缝合方式不同将其分为两组,观察组以棒球法缝合,对照组以传统连续法缝合,每组各30例。对比两组患者的围术期指标(创面缝合时间、手术总时长、术中出血量、术后住院时长、肛门排气时间、首次下地活动时间、血红蛋白降低值)、血清性激素[雌二醇、促卵泡激素(FSH)、促黄体生成素(LH)]、疼痛程度、切口美观度及并发症发生情况。结果两组的创面缝合时间、手术总时长比较,差异均无统计学意义(P>0.05);观察组的术中出血量、术后住院时长、肛门排气时间、首次下地活动时间、血红蛋白降低值分别为(288.45±20.45)mL、(5.16±1.11)d、(17.14±2.13)d、(5.17±0.88)d、(2.03±0.42)g/L,均低于对照组[(316.45±23.59)mL、(6.57±1.63)d、(19.54±1.98)d、(6.03±1.03)d、(3.04±0.51)g/L],差异均有统计学意义(P<0.05)。手术后1周,观察组患者的血清雌二醇、FSH水平分别为(71.22±1.48)ng/L、(20.14±1.88)U/L,均明显低于对照组[(78.98±1.57)ng/L、(23.57±1.96)U/L],LH水平为(10.88±1.34)U/L,明显高于对照组[(9.31±1.26)U/L],差异均有统计学意义(P<0.05)。手术后1周,观察组VAS评分为(4.36±1.21)分,低于对照组[(5.48±1.06)分],CS评分为(22.85±1.03)分,明显高于对照组[(17.95±3.75)分],差异均有统计学意义(P<0.05)。观察组患者并发症发生率为3.33%,明显低于对照组(26.67%),差异有统计学意义(P<0.05)。结论腹腔镜下巨大子宫肌瘤剔除术中应用棒球缝合法效果优于传统连续缝合法,可有效减少术中出血量,缩短术后恢复时间,改善血清性激素水平,提高术后切口美观度,减轻切口疼痛程度,并不会增加手术时间与创面缝合时间,且可降低术后并发症发生率,值得临床推广应用。

Objective To study the effect of baseball suture on postoperative recovery in patients with laparoscopic myomectomy for giant uterine fibroids.Methods By retrospective analysis,60 patients admitted to Taiyuan Central Hospital from January 2022 to January 2023 who underwent laparoscopic removal of giant uterine fibroids were regarded as the observation subjects.According to different suture methods,the observation group was sutured with baseball method,and the control group was sutured with traditional continuous method,with 30 cases in each group.The perioperative indicators(wound suture time,total operation time,intraoperative blood loss,postoperative hospitalization stay,anal exhaust time,first floor activity time,hemoglobin reduction value),serum sex hormone[estradiol,follicle-stimulating hormone(FSH)and luteinizing hormone(LH)],pain degree,incision aesthetics and complication rate were compared between the two groups.Results There were no statistically significant differences in wound suturing time and total operation time between the two groups(P>0.05);the intraoperative blood loss,postoperative hospital stay,anal exhaust time,first floor activity time,and hemoglobin reduction value in the observation group were(288.45±20.45)mL,(5.16±1.11)d,(17.14±2.13)d,(5.17±0.88)d,and(2.03±0.42)g/L,respectively,which were lower than those in the control group[(316.45±23.59)mL,(6.57±1.63)d,(19.54±1.98)d,(6.03±1.03)d,and(3.04±0.51)g/L],the differences were statistically significant(P<0.05).At one week after surgery,the levels of serum estradiol and FSH in observation group were(71.22±1.48)ng/L and(20.14±1.88)U/L,respectively,which were significantly lower than those in the control group[(78.98±1.57)ng/L,(23.57±1.96)U/L],and the level of LH was(10.88±1.34)U/L,which was significantly higher than that in the control group[(9.31±1.26)U/L],the differences were statistically significant(P<0.05).At one week after the operation,the VAS score of the observation group was(4.36±1.21)points,which was lower than that of the control group[(5.48±1.06)points],while the CS score was(22.85±1.03)points,which was significantly higher than that of the control group[(17.95±3.75)points],the differences were statistically significant(P<0.05).The incidence of complications of the observation group was 3.33%,which was significantly lower than that of the control group(26.67%),and the difference was statistically significant(P<0.05).Conclusion The effect of baseball suture during laparoscopic removal of giant uterine fibroids is better than that of traditional continuous suture,which can effectively reduce intraoperative blood loss,shorten postoperative recovery time,improve serum sex hormone level,improve postoperative incision aesthetics,reduce incision pain,and do not increase surgical time and wound suture time,and can reduce the incidence of postoperative complications.It is worthy of clinical application.