阴式子宫切除分碎术与经腹子宫切除对比分析  

Comparison of vaginal hysterectomy with morcellation and abdominal hysterectomy

作　　者：唐家龄[1] 叶明[1] 黄子健[1] 肖青[1] 黄峥[1] 袁健文[1] 

机构地区：[1]广州市妇婴医院,510180

出　　处：《中国妇产科临床杂志》2005年第2期109-111,共3页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的　评价阴式子宫切除分碎术 (VHM)的优点及手术结局 ,并与腹式子宫切除术 (TAH)作对比分析。方法　回顾分析 1999年 4月～ 2 0 0 3年 3月应用分碎术经阴道切除子宫 5 10例 (研究组 ) ,同期行TAH5 5 6例 (对照组 ) ,对两组患者的年龄、体重指数 (BMI)、产次、手术时间、失血量、子宫重量、手术并发症、住院时间及费用进行比较。结果　研究组均成功经阴道完成手术 ,未使用腹腔镜协助。两组患者年龄、产次、BMI差异无显著性。手术时间研究组明显短于对照组 (85 18± 2 7 6 1)min <(113 5 8± 30 97)min ,术中失血量研究组 (12 0 36± 98 5 3)ml明显少于对照组 (198 78± 12 3 0 2 )ml,(P <0 0 0 1)。平均子宫重量腹式组 (36 8 92± 30 6 0 4 )g大于阴式组 (2 6 0 6 4± 10 7 88)g ,住院费用阴式组 5 2 4 7 6 2元低于腹式组 6 833 87元。两组患者均无膀胱或直肠损伤。结论　本文证实阴式子宫切除术中应用分碎术 ,即使是大子宫 ,也是安全便利的 。Objective To evaluate the benefits and outcomes of patients who underwent vaginal hysterectomy with morcellation(VHM)or transabdominal hysterectomy(TAH).Methods Medical records of 510 patients(study group)who underwent VHM and of 556 patients(control group)who underwent TAH from April 1999 to March 2003 were reviewed.The patient age,body mass index(BMI),parity,uterine weight,operative time,blood loss,surgical complications,length of hospital staying and hospital charges were compared.Results Hysterectomy was successfully completed by the intended vaginal route in each study patient without laparoscopic assistance.No significant difference in patient age,parity,BMI were observed between the two groups.Operative time was significantly shorter in VHM group than TAH group[(85.18±27.61)min vs.(113.58±30.97)min].Surgical blood loss was less in VHM group than TAH group[(120.36±98.53ml)vs.(198.78±123.02)ml,P<0.001].Mean uterine weight was greater in the TAH group than VHM group[(368.92±306.04)g vs.(260.64±107.88)g].Hospital charges for VHM were lower than TAH(5247.62 RMB vs.6833.87 RMB).No bladder or rectum injury occurred.Conclusions This study illustrates that uterine morcellation at the time of vaginal hysterectomy is safe and feasible and is associated with decreased hospital charges compared to the abdominal route,even for enlarged uteri.

关 键 词：对照组 阴式子宫切除 患者 腹式 经腹 TAH 产次 手术时间 对比分析 BMI 

分 类 号：R713[医药卫生—妇产科学]