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经腹子宫肌瘤剔除术中横行与纵行子宫切口的出血量比较:一项随机对照试验。

Blood loss from transverse versus longitudinal uterine incision in abdominal myomectomy: a randomized controlled trial.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Abbaseyya Square, Cairo, Egypt.

出版信息

BMC Womens Health. 2020 Dec 28;20(1):259. doi: 10.1186/s12905-020-01113-3.

Abstract

BACKGROUND

It is unclear whether transverse uterine incision is non-inferior to longitudinal incision during myomectomy with regard to bleeding. Our aim was to compare between transverse and longitudinal uterine incisions in myomectomy.

METHODS

A parallel randomized controlled single-blinded study in a university affiliated hospital, in the period between January 2017 and April 2018, in which 52 women candidates for abdominal myomectomy were randomized into transverse uterine incision or longitudinal uterine incision groups (26 in each group). Intraoperative blood loss (estimated directly by blood volume in suction bottle and linen towels and indirectly by difference between preoperative and postoperative hematocrit), operative time and postoperative fever were analyzed.

RESULTS

No statistically significant difference was found between transverse and longitudinal incisions regarding intraoperative blood loss (389.7 ± 98.56 ml vs 485.04 ± 230.6 ml respectively, p value = 0.07), operative time (59.96 ± 16.78 min vs 66.58 ± 17.33 min respectively, p value = 0.18), and postoperative fever (4% vs 8.33%, p value = 0.6).

CONCLUSION

Transverse uterine incision does not cause more blood loss than longitudinal incision and is a reasonable option during abdominal myomectomy.

TRIAL REGISTRATION

NCT03009812 at clinicaltrials.gov, registered January 2017.

摘要

背景

在子宫肌瘤剔除术中,横切口与纵切口在出血方面的优劣尚不清楚。本研究旨在比较子宫肌瘤剔除术中横切口与纵切口。

方法

这是一项在大学附属医院进行的平行随机对照单盲研究,研究时间为 2017 年 1 月至 2018 年 4 月,共纳入 52 例拟行腹式子宫肌瘤剔除术的患者,随机分为横切口组或纵切口组(每组 26 例)。分析术中出血量(直接通过吸引瓶和手术巾上的血量以及术前和术后血细胞比容差值来估计)、手术时间和术后发热情况。

结果

横切口组与纵切口组术中出血量(分别为 389.7±98.56ml 和 485.04±230.6ml,p 值=0.07)、手术时间(分别为 59.96±16.78min 和 66.58±17.33min,p 值=0.18)和术后发热(分别为 4%和 8.33%,p 值=0.6)差异均无统计学意义。

结论

与纵切口相比,横切口不会增加出血量,在腹式子宫肌瘤剔除术中是一种合理的选择。

试验注册

NCT03009812 于 clinicaltrials.gov 注册,注册日期为 2017 年 1 月。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/519d/7768654/6320c746b136/12905_2020_1113_Fig1_HTML.jpg

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