大子宫经阴道与经腹子宫切除术对比分析  

Comparison of Trans-vaginal and Trans-abdominal Hysterectomy for Enlarged Uteri

作　　者：冯琼[1] 唐家龄[1] 叶明[1] 黄子健[1] 李玉芳[1] 肖青[1] 

机构地区：[1]广州市妇婴医院,广东广州510180

出　　处：《实用妇产科杂志》2006年第6期348-350,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:对大子宫经阴道与经腹子宫切除术的优点及手术结局进行比较。方法:随机研究1999年4月至2004年3月因子宫肌瘤有症状行子宫切除术者,其中385例大子宫行阴式子宫切除术(研究组)与269例腹式子宫切除术(对照组Ⅰ)及130例子宫<200 g的阴式子宫切除术(对照组Ⅱ)作对比分析。研究组与对照组Ⅰ子宫重量均达200g^1200 g,研究组在术中采用了子宫分碎术。结果:3组患者年龄、体重指数(BMI)及产次差异无显著性。阴式子宫切除术手术时间明显短于腹式(76分钟,61分钟与108分钟)。住院时间研究组(6.5天)、对照组Ⅱ(6.2天)短于腹式组(6.9天)。术后并发症(发热或感染)腹式组较阴式组增多(8.9%,2.1%与1.6%)。结论:经阴道子宫切除术与腹式子宫切除术相比,手术时间短,住院时间少,并发症低,即使是大子宫,对许多患者都是安全可行的。To compare the advantages and outcomes of trans-vaginal and trans-abdominal hysterectomy in patients with enlarged uteri. Methods： 385 trans-vaginal hysterectomy for enlarged uteri （ study group） were compared with two control group：group Ⅰ （269 trans-abdominal hysterectomy）, group Ⅱ （130 trans-vaginal hysterectomy for uterine weights 〈200 g）.All of patients were performed for symptomatic uterine myoma from April 1999 through March 2004. In the former two enlarged uteri groups, uterine weights ranged from 200 g to 1200 g.The morcellation was used in the study group.Results：There was no significant difference in patient age,BMI and parity among three groups. Operative time was significantly shorter for trans-vaginal route as compared with trans-abdominal route （76min,61min vs 108 min）.Hospital stay was shorter in the study group （6.5 days） and control group Ⅱ （6.2 days） than group Ⅰ （6.9 days）. Postoperative complications （ fever or infection） were increased in the trans-abdominal route （8.9% vs 2.1%, 1.6%）. Conclusions：Our data indicate that trans-vaginal hysterectomy is both feasible and optimal choice for many patients,and is associated with reduced operative time,hospital stay and complications compared with the abdominal route, even for enlarged uteri.

关 键 词：子宫切除术 分碎术 大子宫 腹式 阴式 

分 类 号：R713.4[医药卫生—妇产科学]