剖宫产术子宫切口连续单层缝合与连续套锁缝合的比较研究

目的：比较连续单层缝合、连续套锁缝合在剖宫产术后子宫切VI缝合的效果，选择更好的子宫切VI缝合方法。方法：将300例剖宫产产妇按照子宫切121缝合方法的不同，分为连续单层缝合组（单层组）和连续套锁缝合组（套锁组）各150例。单层组采用连续单层子宫切口缝合法；套锁组采用连续套锁子宫切171缝合法，比较两组围手术期手术时间、术中出血量、术后最高体温、产后出血率、术后恶露时间和住院时间等基本情况，并随访1年，记录两组月经复潮时间、切口假腔发生率和月经不调发生率。结果：单层组手术时间、术后恶露时间分别为（48．46±7．35）111in、（32．8±5．9）d，与套锁组比较差异有统计学意义（P〈0．05）。单层组术中出血量、术后最高体温、产后出血率、住院时间分别为（263．6±112．4）mL、（36．74±0．83）℃、3．33％和（3．7±0．6）d，与套锁组比较差异无统计学意义（P〉O．05）。两组均随访1年。单层组术后1年内切口假腔发生率和月经不调发生率分为2．67％和8．67％，与套锁组比较差异有统计学意义（P〈O．05）。单层组月经复潮时间为（4．46±2．18）个月，与套锁组比较差异无统计学意义（P〉O．05）。结论：相比于连续套锁缝合，连续单层缝合可以缩短手术时间，减少术后恶露时间，并且降低切口假腔发生率和月经不调发生率，值得在临床实践中推广运用。

The Comparison Research about Uterine Incision Suture between Continuous Single-layer Suture and Continuous Lock Stitch Suture after Cesarean Section

Objective：To compare the effect of continuous single-layer suture and continuous lock stitch suture in the uterine incision suture after cesarean section,to select better suture method.Method：Based on the suture method, 300 cases of cesarean section were divided into continuous single-layer suture group（single group）and continuous lock stitch suture group（lock group）with 150 cases in each.Single group used continuous monolayer of uterine incision suture;lock group used lock stitch suture.The operation time,the amount of operative bleeding,postoperative highest temperature,postpartum hemorrhage rate,the basic situation of lochia after operation and hospitalization time were compared.The follow up time was one year to record menses time,incision false lumen and the incidence of irregular menstruation.Result：The operation time and the lochia time of single group after operation were（48.46±35）min, （32.8＆#177;5.9）d respectively,which were significant differences compared to the lock group（P〈0.05）.The intraoperative bleeding volume,postoperative highest temperature,the rate of postpartum hemorrhage,the hospitalization time of single group was（263.6±112.4）mL,（36.74±0.83）℃,3.33%,and（3.7±0.6）d,which were no significant difference compared with lock group（P〉0.05）.The two groups were followed up for one year.Incision false lumen incidence and irregular menstruation occurrence rate of single group after one year were 2.67% and 8.67%,which were statistical difference compared with the lock group（P〈0.05）.The menses time of single group was（4.46±2.18）months,which had no significant difference compared to the lock group（P〉0.05）.Conclusion：Compared to the continuous lock stitch suture,continuous single-layer suture can shorten operation time,reduce postoperative lochia time,and the incidence rate of incision falselumen,which is worth to be popularized in clinical practice.