Guluzar Arzu Turan, MD, Department of Obstetrics and Gynecology, Sifa University Hospital, Izmir, Turkey.
Esra Bahar Gur, MD, Sifa University Hospital, Izmir, Turkey.
Pak J Med Sci. 2014 May;30(3):530-4. doi: 10.12669/pjms.303.4545.
Comparing locked and unlocked uterine closure techniques in terms of bleeding control and uterine incision healing.
The patients undergoing cesarean section in Sifa University Hospital between May - October 2012 were accepted to this prospective controlled study. Primarily, safety was evaluated. The hemoglobin count (HC) and serum creatine kinase (CK) levels of the patients in the locked (n = 47) and unlocked (n = 35) groups were measured just before and 24 hours after operation. Hemoglobin deficit, increase in CK and the additional hemostatic sutures were compared. Secondly, uterine scar healing was evaluated three months later. Scar thickness, niche and percentage of thinning of the scar region of the locked (n = 27) and unlocked (n = 32) groups were calculated and compared.
The hemoglobin deficit was similar in two groups. CK rise was less in the unlocked group but it was not significant (P = 0.082). Unlocked group needed more additional sutures (P = 0.016). The thickness of the niche and the percentage of thinning of the scar region were significantly less in the unlocked group (P= 0.002, P=0.000).
Unlocked uterine closure technique is safe and has less damage to the myometrium.
比较锁扣式与非锁扣式子宫缝合技术在控制出血和子宫切口愈合方面的效果。
选择 2012 年 5 月至 10 月在西法大学医院行剖宫产术的患者，进行前瞻性对照研究。首先评估安全性。测量锁扣组（n = 47）和非锁扣组（n = 35）患者手术前后即刻的血红蛋白（Hb）计数和血清肌酸激酶（CK）水平。比较血红蛋白缺失量、CK 升高值和额外止血缝线的使用情况。其次，术后 3 个月评估子宫瘢痕愈合情况。计算并比较锁扣组（n = 27）和非锁扣组（n = 32）的瘢痕厚度、凹陷和瘢痕变薄百分比。
两组的血红蛋白缺失量相似。非锁扣组 CK 升高较少，但无统计学意义（P = 0.082）。非锁扣组需要更多的额外缝线（P = 0.016）。非锁扣组的凹陷深度和瘢痕变薄百分比明显较小（P= 0.002，P=0.000）。
非锁扣式子宫缝合技术安全，对子宫肌层的损伤较小。
