全宫术阴道残端三种缝合方式效果比较

我们对1981年至1989年在我科行全宫术的450个病例进行统计分析,其中间断褥式缝合230例,连续锁边缝合116例,“8”字缝合84例,各组术后阴道残端并发症(出血、感染、息肉、裂开及外露)的发生率分别为22.6％,43.10％和46.43％,经x~2检验,间断褥式缝合的并发症发生率与另两种缝合的并发症发生率相差均非常显著,P<0.01;而另两种缝合的并发症发生率间的相差不显著,P>0.05。结果提示:间断褥式缝合阴道残端的效果最佳,而连续锁边和“8”字缝合的效果较差。我们认为:在全宫切除术缝合阴道残端时,应首选间断褥式缝合法。

Comparison of Three Sutures Closing The Upper End of Vagina in Total Hysterectomy

In this paper, 430 cases of total hysteretomy were analyzed. For closing the upper end of vagina, three different sutures (230 cases for interrupted mattress suture; 116 for continuous lockstitck and 84 for figure-of-eight suture) were carried out. The incidences of complications caused by these three sutures were 22.6%, 43.1% and 46.4%, respectively. The main complications were bleeding, infection, polyp, split and external betraying. With respect to all of the complications induced by the interrupted mattress,stitch was much less than other two sutures (X~2=27 and X~2=29, P<0.001), but the incidences of complications between figure-of-eight sutures group and continuous lockstitch group did no reveal significant difference. We regarded interrupted mattress suture is a most effective method and it should be first selected for the closure of the upper end of vagina in hysteretomy.