Objective To evaluate the effects of different suture methods on rnyometrial thickness after cesarean section.Methods Altogether 198 pregnant women who received cesarean section in Dalian Maternal and Child Health Care Hospital and Dalian Women and Children Medical Center from February 2013 to March 2015 were selected and randomly divided into single layer locked group (group A),double layer with first layer locked group (group B) and double layer with first layer unlocked (group C) with 66 cases in each group.Blood loss,operation time and postoperative complications were recorded.Residual myometrial thickness (RMT),total myometrial thickness (TMT),scar defect ratio (RMT ＜ 2.30 ram) and healing ratio were assessed at 6 months after birth.Results All patients underwent surgery successfully.There were 64 cases,63 cases and 64 cases accomplishing study in three groups.There were no significant differences among three groups in operation time and blood loss (F value was 0.630 and 2.338,respectively,both P ＞ 0.05).There were significant differences in RMT,scar defect ratio,TMT and healing ratio among three groups (F/x2 value was 5.501,8.963 and 4.159,respectively,all P ＜ 0.05).Group comparison showed that RMT and healing ratio in group C were better than those in group A and group B but scar defect ratio in group C was lower than that in group A and group B (t value was 4.556,6.171,5.939,5.112,7.231 and 4.082,respectively,all P ＜ 0.025).There was no significant difference among groups in remaining indicators (t/x2 value was 0.978,1.039,2.865,3.042 and 2.958,respectively,all P ＞ 0.025).Conclusion Decidua wrapping and suture-locking are main influencing factors affecting myometrium healing,and method of double layer with first layer unlocked relieves scar defects significantly.%目的 比较剖宫产术后不同缝合方法对子宫肌层厚度的影响.方法 选择2013年2月至2015年3月在大连市妇幼保健院和大连市妇女儿童医疗中心接受剖宫产手术的孕妇198例,随机分为单层锁边缝合(A组)、双层锁边缝合(B组)和双层不锁边缝合(C组)各66例,记录三组术中出血量、手术时间和术后并发症,评价三组产后6个月残余肌层厚度(RMT)、总肌层厚度(TMT)、瘢痕缺陷比例(RMT＜2.30mm)和愈合比例.结果 所有患者均顺利完成手术,三组各有64例、63例和64例患者完成研究;三组手术时间和术中出血量组间比较差异无统计学意义(F值分别为0.630、2.338,均P＞0.05),而RMT、瘢痕缺陷比例、TMT和愈合比例组间比较差异有统计学意义(F/x2值分别为5.501、8.963、4.159,均P＜0.05);两两比较结果表明,c组RMT、愈合比例大于A组和B组,而瘢痕缺陷比例小于A组和B组,组间比较差异均有统计学意义(￡值分别为4.556、6.171、5.939、5.112、7.231、4.082,均P＜0.025),其余指标组间比较差异无统计学意义(t/x2值分别为0.978、1.039、2.865、3.042、2.958,均P＞0.025).结论 蜕膜包裹和锁边缝合是子宫肌层愈合的主要影响因素,双层不锁边缝合对减轻瘢痕缺陷有明显帮助.
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