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剖宫产子宫切口单层缝合中连续缝合与间断缝合的比较

Continuous vs interrupted sutures for single-layer closure of uterine incision at cesarean section.

作者信息

Hohlagschwandtner M, Chalubinski K, Nather A, Husslein P, Joura E A

机构信息

University Hospital of Vienna, Department of Obstetrics and Gynecology, Waehringer Guertel 18-20, 1090 Vienna, Austria.

出版信息

Arch Gynecol Obstet. 2003 Apr;268(1):26-8. doi: 10.1007/s00404-002-0308-5. Epub 2002 May 7.

Abstract

In a non-randomized cohort study, we compared continuous with interrupted sutures for the closure of the lower uterine segment at cesarean section. Eighty-two women, who underwent cesarean section at the Department of Obstetrics at the University Hospital of Vienna between January and May 2000, were included in the study. Thirty-eight patients had single-layer closure of the lower uterine segment and 43 patients had closure with interrupted sutures. There were significant differences in total operating-time (32 min vs 40 min, P=0.001) and in the pre- and postoperative maternal hemoglobin (DeltaHb 0.6 g/dl vs 1.1 g/dl, P<0.01), but there was no significant difference in sonographically diagnosed hematomas (32% vs 21%, P=0.27). No woman had fever, the median hospitalization time was 6 days, and there were no re-admissions. In both groups, the median need for analgesics was 150 mg diclofenac ( P=0.22). Continuous single-layer closure of the lower uterine segment at cesarean section saves operating time, reduces blood loss, and introduces less foreign material into the wound.

摘要

在一项非随机队列研究中,我们比较了剖宫产术中子宫下段连续缝合与间断缝合的效果。纳入了2000年1月至5月间在维也纳大学医院妇产科接受剖宫产的82名女性。38例患者采用子宫下段单层连续缝合,43例患者采用间断缝合。两组在总手术时间(32分钟对40分钟,P = 0.001)以及术前和术后母体血红蛋白水平(血红蛋白差值0.6 g/dl对1.1 g/dl,P < 0.01)方面存在显著差异,但超声诊断的血肿发生率无显著差异(32%对21%,P = 0.27)。没有女性发热,中位住院时间为6天,且无再次入院情况。两组中,镇痛药的中位需求量均为150毫克双氯芬酸(P = 0.22)。剖宫产术中子宫下段连续单层缝合可节省手术时间、减少失血,并减少伤口内的异物植入。

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