经阴道根治性子宫切除术治疗子宫恶性肿瘤的临床研究  

A Clinical Study of Transvaginal Radical Hysterectomy for Treating Uterine Neoplasm

作　　者：李峰娟[1] 陈春林[1] 郭遂群[1] 赵杉珊[1] 刘国炳[1] 刘萍[1] 张雪玉[2] 孔欣[3] 徐燕[4] 钟梅[1] 余艳红[1] 

机构地区：[1]南方医科大学南方医院妇产科,广州510515 [2]宁夏医学院附属医院妇产科,宁夏750004 [3]武警广东总队医院妇产科,广东510507 [4]广州市番禺区人民医院妇产科,广州511400

出　　处：《肿瘤预防与治疗》2008年第4期394-397,共4页Journal of Cancer Control And Treatment

摘　　要：目的:评估经阴道根治性子宫切除术(VRH)治疗子宫恶性肿瘤的临床效果。方法:对43例子宫恶性肿瘤患者行VRH手术,分析术中、术后恢复及随访情况。结果:(1)43例患者均成功实施VRH手术,手术时间60.10min±19.00min,术中出血量230.00ml±192.25ml。(2)切除子宫主韧带长度:左侧3.39cm±0.31cm,右侧3.28cm±0.47cm;切除骶子宫韧带长度:左侧3.45cm±0.35cm,右侧3.60cm±0.36cm;切除阴道长度:前壁3.33cm±0.66cm,后壁4.28cm±0.64cm。所有切除组织边缘病理检查均未见癌细胞。(3)手术副损伤:损伤膀胱1例,损伤右侧输尿管1例,泌尿系损伤率为4.65%(2/43)。(4)术后恢复情况:术后患者肛门排气时间42.6h±18.1h,拔尿管时间13.48d±8.07d,残余尿量51.14ml±27.39ml,住院时间15d±9.4d。(5)术后并发症:发生尿潴留2例,淋巴囊肿1例,合计发生率6.98%(3/43)。(6)术后随访:16.93±4.34月,肿瘤复发2例,复发率4.65%(2/43)。结论:对子宫恶性肿瘤施行VRH能达到足够的切除范围,该手术创伤小、术后恢复快,是治疗子宫恶性肿瘤的理想术式。Objective： To assess the clinical effect of transvaginal radical hysterectomy （VRH）for treating uterine neoplasm. Methods： Radical vaginal hysterectomy was performed in 43 patients with uterine neoplasm. The process of operation, postoperative recovery condition and follow-up situation were analyzed. Results： （ 1 ） VRH were successfully accomplished in all of the 43 patients. The average time of surgery was（60.10 ± 19.00） min and the average hemorrhage volume was 230.00ml ± 192.25ml. （2） The length of excised cardinal ligaments（CL） ： left 3.39cm ± 0. 31 cm, right 3.28cm ± 0.47 cm; the length of excised uterosacral ligaments（USL） ： left 3.45cm ± 0.35 cm, right 3.60cm ± 0.36cm; the length of excised vaginal： anterior 3.33cm ± 0. 66 cm, posterior 4.28cm ± 0. 64 era. All surgical margins were macroscopicaUy negative. （3） the operation complication of injury ： one case got bladder injury, one got the right urethra injury, with the the urinary system injury rate of 4.65% （2/43）. （4）Postoperative recovery condition： the mean time for passage of gas by anus was 42.6h ± 18. 1h, the mean time of stubbs catheter maintenance was 13.48d ± 8.07d, the mean volume of residual urine was 51.14ml ± 27.39ml, and the mean time for patients in hospital was 15d ± 9.4d（5） Postoperative complications： two cases had urinary retention, one case had lymphocele, with the rate of 6.98% （3/43）. （6）The follow-up situation： There were 2 cases of recurrences with the rate of 4.65% （ 2/43 ） in average follow up time of 16.93 ± 4. 34 months. Conclusion： For the treatment of uterine neoplasm, VRH decreases operative damage with shorter recovery time, which has the same operative extent as laparotomy. It is an ideal approaeh to treat uterine neoplasm.

关 键 词：经阴道 根治性子宫切除术 子宫恶性肿瘤 

分 类 号：R713.42[医药卫生—妇产科学] R737.33[医药卫生—临床医学]