腹腔镜鞘膜内子宫切除术宫颈残端的处理  

The treatment of cervical stump after laparoscopic intrathecal hysterectomy

作　　者：蒋蓉[1] 董俊英[1] 

机构地区：[1]汉中市人民医院,陕西汉中723000

出　　处：《腹腔镜外科杂志》2009年第9期708-709,共2页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜鞘膜内子宫切除术术后宫颈残端的处理。方法:统计我院2003年2月至2008年1月因妇科良性病变行腹腔镜鞘膜内子宫切除术254例患者的临床资料,随机分为对照组和研究组Ⅰ,研究组Ⅱ,研究组Ⅲ,对照组63例用Semm宫颈缝合法;研究组Ⅰ62例用内凝棒法,研究组Ⅱ64例用油纱填塞法,研究组Ⅲ65例为改良式宫颈缝合法,比较4组患者术中阴道出血量、宫颈处理时间、术后阴道出血量及出血时间、平均住院时间、术后并发症发生率、随访情况。结果:对照组和研究组术中宫颈处理时间、术后并发症发生率差异有统计学意义(P<0.01)。结论:4种方法均适用于腹腔镜鞘膜内子宫切除术,但Semm宫颈缝合法手术时间长、术后并发症多,而研究组3种方法均具有操作简单、手术时间短、术后并发症少的优点,更有利于妇科微创手术的开展。Objective：To discuss the treatment of cervical stump after laparoscopic intrathecal hysterectomy. Methods：Two hundred and fifty-four patients ,who underwent laparoseopic intrathecal hysterectomy due to gynecological benign lesions in People＇s hospital of Hanzhong City from Feb. 2003 to Jan. 2008, were randomly divided into control group and study groups I , Ⅱ, Ⅲ. The control group included 63 patients who were treated by Semm cervical suture, the study group I included 62 cases who were treated by internal congealing stick, the study group Ⅱ was packing group which included 64 cases treated by oil gauze, the study group Ⅲwas suturing group which included 65 cases treated by improved cervical sutures. Then, the amount of vaginal bleeding, the time of cervical processing, the amount and time of vaginal bleeding after operation, the average hospital stay, postoperative complications and follow-up situation were compared among the four groups of patients. Results：The time of cervical processing and postoperative complications of control group were significantly different from study groups（ P 〈 0.01 ）. Conclusions：The four kinds of methods are all suitable for laparoscopic intrathecal hysterectomy. But the Semm cervical suture needs more time, and has more postoperative complications. While the three study groups have advantages of simple operating, shorter surgery time,and less postoperative complications,which are favorable for carrying on gynecologic minimally invasive surgery.

关 键 词：腹腔镜术 子宫切除术 宫颈残端 

分 类 号：R713.42[医药卫生—妇产科学]