全子宫切除术手术途径和适应证10155例分析  

Surgical approaches and indications associated with hysterectomies:analysis of 10 155 cases

作　　者：谭先杰[1] 郎景和[1] 刘珠凤[1] 孙大为[1] 冷金花[1] 朱兰[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院妇产科,北京100730

出　　处：《中国实用妇科与产科杂志》2008年第5期360-362,共3页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：北京科技新星计划人才培养项目(2003A025)

摘　　要：目的探讨全子宫切除术的手术途径和适应证及其变化。方法调用北京协和医院1996～2006年全子宫切除术患者病案首页资料，根据手术方式分为开腹子宫切除术、阴式子宫切除术和腹腔镜子宫切除术3组。对各组手术适应证及其变化进行回顾性分析。结果开腹子宫切除术占70．9％，腹腔镜子宫切除术占20．6％，阴式子宫切除术占8．5％。腹腔镜子宫切除所占比例从1996年2．4％上升到2006年的25．4％。全子宫切除术的常见手术适应证为子宫肌瘤（53．3％～56．2％）、子宫内膜异位症（含子宫腺肌病）（17．5％～19．1％）、良性卵巢肿瘤（7．8％～9．2％）以及生殖道脱垂（7．6％～7．7％）。相比1996～2001年，2002～2006年因宫颈病变和子宫内膜病变行全子宫切除术的比例增加，通过腹腔镜途径处理者增多。结论采用腹腔镜子宫切除术逐渐增加，手术适应证与开腹子宫切除术趋于一致。宫颈病变和子宫内膜病变在子宫切除术的适应证中所占比例有增加趋势，而且通过腹腔镜途径处理者增多。Objective To examine the approaches of hysterectomies and their indications. Methods Hospital discharge record data on hysterectomies performed in Peking Union Medical College （PUMC） Hospital from 1996 to 2006 were retrieved. Cases were classified into three groups： abdominal, laparoscopic and vaginal hysterectomy. Operative indications for hysterectomy were analyzed retrospectively and compared with data in literatures. Results Records of 10155 women who underwent hysterectomies due to benign or certain malignant gynecological conditions were analyzed. Operations ineluded abdominal （70. 9% ） , laparoscopic （20. 6% ） and vaginal （8. 5% ） hysterectomy. The proportion of laparoscopic hysterectomy increased from 2.4% in 1996 to 25.4% in 2006. The common indications for hysterectomy were uterine leiomyoma （ 53.3% ～ 56.2% ）, endometriosis including adenomyosis （ 17. 5% ～ 19. 1% ）, benign ovarian tumor （7. 8% ～9. 2% ）, and genital prolapse （7. 6% ～7. 7% ）. Compared with 1996 ～2001, more patients with cervical lesion and endometrial lesion received standard total hysterectomy and more treated via laparoscope. Conclusion Laparoscopic hysterectomy has been increasingly used in PUMC hospital, with similar operative indications to abdominal hysterectomy. Increasing number of patients with cervical and endometrial lesions receive standard total hysterectomy and are treated more via laparoscope.

关 键 词：子宫切除术 腹腔镜 

分 类 号：R71[医药卫生—妇产科学]