宫颈癌根治术后阴道缩短的预防及影响因素  

The Influential Factors and Prevention of Vaginal Shortening After Radical Hysterectomy in the Patients with Uterine Cervix Cancer

作　　者：李玉芝[1] 李红雨[2] 孙蕊[1] 李燕华[1] 

机构地区：[1]蚌埠医学院附属医院妇瘤科,安徽蚌埠233004 [2]蚌埠医学院第二附属医院妇产科

出　　处：《解剖与临床》2006年第3期169-171,共3页Anatomy and Clinics

摘　　要：目的:探讨宫颈癌根治术后预防阴道缩短的方法及影响因素。方法:73例宫颈癌根治术患者,分为两组,A组41例,阴道残端敞开缝合,术后多次行阴道扩张;B组32例,阴道残端闭合缝合。观察两组术后并发症,术后6个月测量阴道长度。结果:两组阴道长度分别为(6.57±0.63)cm、(4.78±0.46)cm(P<0.001)。在A组中保留卵巢与未保留卵巢患者术后阴道长度分别为(7.01±0.36)cm、(6.25±0.68)cm(P<0.05);放疗与未放疗者术后阴道长度分别为(5.92±0.57)cm、(6.93±0.32)cm(P<0.05)。两组盆腔感染率和尿潴留的发生率比较无显著差异(P>0.05)。无一例发生疝及大出血。结论:宫颈癌根治术中阴道残端敞开缝合,术后多次扩张阴道对术后阴道有延长作用。保留卵巢、不放疗或卵巢移位、恰当的手术范围、术后减少感染是防止阴道缩短的积极因素。阴道敞开缝合不增加盆腔感染率和尿潴留发生率。Objective： To investigate the influence factors and prevention of vaginal shortening following radical hysterectomy in the patients with uterine cervix cancer （UCC）. Methods： 73 cases with UCC were divided into A （n = 41） and B group （n = 32）. The patients from A group received open suturation of vaginal stump, and multiple pastoperative colpectasia. The Patients in B group suffered from closed suturation of vaginal stump. The postoperative complications appeared in both group were monitored. Six months after operation, we measured the lengths of vagina. Results： The average of vaginal lengths （AVL） in the patients of A group was 6.57 cm, which was longer than 4.78 cm that was AVL in B group （P 〈 0.001）. In group A, the AVL in patients whose ovaries be retained was 7.01 cm, which was longer than 6.25 cm in the patients who underwent oophorectomy （P 〈 0.05）; moreover, the AVL of the patients received past - operation radiotherapy was 5.92 cm, which was shorter than 6.93 cm of the patients without receiving post - operation radiotherapy （P 〈 0.05）. The infection rates of pelvic cavity and uroschesis were not significant deviation between A and B group （ P 〉 0.05）. No hernia and hemorrhea appeared in these patients. Conclusion： Open suturation of vaginal stump and multiple pestoperative colpectasia could extend the AVL in patients underwent radical hysterectomy. Reserving ovaries, no postoperative radiotherapy, appropriate operative realm and decreasing pestoperative infection are positive factors to prevent these patients from vagina shortening. Open suturation of vaginal stump does not increase the incidence of pelvic infect and uroschesis.

关 键 词：宫颈癌 手术 阴道缩短 预防 

分 类 号：R737.33[医药卫生—肿瘤] R713[医药卫生—临床医学]