改进阴式子宫切除术的临床研究  

Clinic study of improved transvaginal hysterectomy

作　　者：吴美艳[1] 郭艳军[1] 邓岳红[1] 

机构地区：[1]航天中心医院妇产科,北京100049

出　　处：《中华临床医师杂志（电子版）》2011年第16期4745-4750,共6页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的本研究通过对改进阴式子宫切除术与常规阴式子宫切除术的术中及术后情况进行比较,评价改进式效果,进而探讨非脱垂子宫阴式切除的手术方法技巧及效果,提高手术水平。方法回顾性分析2002年5月至2010年3月我院对非脱垂子宫良性病变行阴式子宫切除术62例患者的临床资料,其中改进式32例、传统式30例,对围手术期及术后随访情况的一些指标(术中出血量、手术时间、术后体温恢复时间、术后病率、拔除尿管、排气时间、术后镇痛率、术后抗生素使用时间、术后住院天数等)分别进行记录。结果 (1)两组患者围手术期的情况比较:改进组平均手术时间缩短、出血量减少、术后病率小、抗生素使用时间短、住院时间短,与常规组相比差异有统计学意义(P<0.05)。(2)两组患者术后长期疗效随访情况比较:随访例数、阴道残段肉芽组织发生率、阴道残端线头发生率、术后1个月恢复正常工作生活比例等差异均无统计学意义(P>0.05)。结论改进阴式全子宫切除术简化了操作步骤,减少了副损伤,减少了术中出血并缩短了手术时间,术后恢复更快,达到了微创的目的,阴式手术切除子宫更易掌握,值得推广。Objective To contrast the intraoperative and postoperative effect of improved transvaginal hysterectomy and conventional transvaginal hysterectomy,evaluate two different methods of transvaginal hysterectomy,and study the surgical technique of transvaginal hysterectomy.Methods A retrospective analysis was made for 62 cases of transvaginal hysterectomy.In these cases,32 were treated by improved transviganl hysterectomy,and 30 were treated by conventional transvaginal hysterectomy.Some indicators were recorded,including blood loss,operating time,the recovery time of postoperative fever,rate of complications,farting time,the time of urinary catheter extraction,analgesics application and antibiotic consumption,and statistical anaylsis were made.Results(1)Comparison of patient's conditions in perioperative period:① intraoperative conditions:there were statistic significances between the improved group and the conventional group on average operating time and blood loss(P<0.05).②post-operative conditions:compared with conventional group,the difference of complication rate,the antibiotic consumption and in-hospital time in improved group had statistic significance.There were no statistic significances between two groups on farting time,analgesics application and time of urinary catheter extraction(P>0.05).(2) Comparison of long-term follow-up effects:there were no statistic significances between two groups on cases of follow up,incidence of granulation tissues in vaginal residual segment,incidence of vaginal stump thrum,cases of recover to normal life in one month after operation(P>0.05).Conclusions Improved transvaginal hysterectomy has fewer operating process,reduce surgical injury and blood loss,shorten operating time and is more easier to master,it worths popularizing.

关 键 词：子宫切除术 阴道式 改进式手术 非脱垂子宫 

分 类 号：R713.4[医药卫生—妇产科学]