腹式子宫切除术中不缝合盆腔脏层腹膜的临床研究  

A clinical study of non-closure of visceral peritoneum at abdominal hysterectomy

作　　者：熊宙芳[1] 董卫红[1] 王泽华[1] 

机构地区：[1]华中科技大学协和医院妇产科,武汉市430022

出　　处：《实用医学杂志》2005年第18期2003-2005,共3页The Journal of Practical Medicine

摘　　要：目的:探讨腹式子宫切除术中不缝合盆腔脏层腹膜对术中、术后影响。方法:2002年1月至2003年12月在我院行腹式子宫切除术的577例患者随机分为两组,观察组(不缝合盆腔脏层腹膜)192例;对照组(缝合盆腔脏层腹膜)365例。分析两组的手术时间、术中失血量、术后并发症、排气时间、止痛药的应用、术后住院时间等情况。结果:不缝合盆腔脏层腹膜的平均手术时间较缝合的少11min,差异有极显著意义(P<0.01)。两组的术中失血量、术后并发症发生率(术后病率、泌尿道感染、切口感染、切口裂开、盆腔脓肿、肠梗阻)、排气时间、应用止痛药、术后住院时间方面差异无显著性(P>0.05)。结论:腹式子宫切除术中不缝合盆腔脏层腹膜缩短手术时间,不增加术后早期并发症的发生,建议在腹式子宫切除术中不必进行腹膜化。Objective To evaluate the clinical outcome of patients who underwent abdominal hysterectomy without closure of visceral peritoneum. Methods Five hundreds and seventy-seven patients undergoing abdominal hysterectomy in our hospital between January 2002 and December 2003 were divided randomly into two groups： visceral peritoneum closed （ n = 365） or visceral peritoneum open （ n = 192） . Statistical analysis compared operation time, blood loss, postoperative complications, bowel function restoration, analgesic requirement and post-operative stay between the two groups. Results Non-closure of the visceral peritoneum reduces operation time by 11 min（ P 〈 0. 01 ） . No difference in the other outcome measures including blood loss, postoperative complications （febrile morbidity, urinary tract infection, wound infection, wound separation, pelvic abscess and ileus）, bowel function restoration, analgesic requirement and post-operative stay （ P 〉 0. 05 ）. Conclusion Non closure of the visceral peritoneum can shorten operative time significantly while not increasing early postoperative complications. It is suggest that the traditional practice of peritoneal closure be abolished at abdominal hysterectomy.

关 键 词：腹式子宫切除术 手术缝合 盆腔脏层腹膜 腹膜化 并发症 失血量 

分 类 号：R713.4[医药卫生—妇产科学]