经阴子宫三角形切除术47例临床观察  

47 cases of clinical observation about triangular resection of the uterus via vaginal

作　　者：刘美兰[1] 郭玉华[2] 于小玲[1] 张艳[2] 李建敏[2] 

机构地区：[1]青岛大学医学院病理生理学教研室,山东青岛266021 [2]山东省高密市人民医院妇科,山东高密261500

出　　处：《中国现代医学杂志》2010年第18期2821-2824,共4页China Journal of Modern Medicine

摘　　要：目的比较经阴子宫三角形切除术、经腹子宫三角形切除术、经腹子宫次全切除术3种不同术式的临床效果,检测两种术式对机体应激的影响,探讨子宫次全切除的最佳术式。方法有子宫切除指征且要求保留宫颈的患者140例,47例行经阴子宫三角形切除术,经腹子宫三角形切除术45例,经腹次全子宫切除术48例。比较3种术式患者的出血量、平均手术时间、术后住院天数、术后病率、术后切口疼痛情况及术后恢复情况等;同时检测两组术前、术后外周血中皮质醇(Cor)变化,以评估3种术式对机体应激的影响。结果经阴子宫三角形切除术组较经腹两组术后切口疼痛轻,恢复肛门排气时间短(23.1±2.76)h,术后病率低(3.50%),住院时间短(6.5±1.78)d,与经腹两组比较差异有显著性(P<0.05)。3组术后24 h外周血中皮质醇均升高,经阴子宫三角形切除术组术后24 h外周血中皮质醇平均为(190.78±56.35)nmol/L,较术前24 h外周血中皮质醇[平均为(121.56±15.46)nmol/L]升高不显著,经腹子宫三角形切除术组术后24 h、外周血中皮质醇平均(397.23±92.39)nmol/L,经腹子宫次全切术组术后24h外周血中皮质醇平均(417.40±82.31)nmol/L,均较术前升高明显,阴式组与腹式两组比较差异有显著性(P<0.05)。结论经阴子宫三角形切除术为无需特殊器材、创伤小、不影响卵巢血供且有利于患者身心康复的微创手术方式,在临床中应用安全可行、值得推广。【Objective】 We separately compared the clinical effects about triangular resection of uterus via vagi-nal and triangular resection of uterus through abdomen and abdominal hysterectomy surgery,then detected the im-pact of stress on the body,further explore the best surgical way on hysterectomy.【Methods】Our research groups include 140 cases of patients who had the indications of hysterectomy and requested the reservation of cervical,there are 47 of patients were carried out triangular resection of uterus via vaginal,45 cases were carried out triangu-lar resection of uterus through abdomen and 48 cases were carried out abdominal hysterectomy surgery.In the above-mentioned three kinds of operation methods,we compared the amount of bleeding in patients,the average op-erative time,postoperative hospital stay,postoperative morbidity,postoperative pain of incision and postoperative re-covery.In order to assess the impact of stress on the body.Before and after surgery,we separately detected the changes about peripheral blood levels of cortisol（Cor） in the three groups.【Results】Compared the surgical of trian-gular resection of uterus via vaginal with the group of triangular resection of uterus through abdomen,the pain of postoperative incisional was weaker,the time of restoring anal exhaust was shorter（23.10±2.76 hours）,postoperative morbidity was lower（3.50%）,hospital stay was shorter（6.50±1.78 days）,and there is statistical significance（P 0.05）between the two groups.The levels of cortisol in peripheral blood were increased 24 hours after the three ways of surgery.In the group of triangular resection of uterus via vaginal,the average value was [（190.78±56.35） nmol/L],compared with before surgery its increased level [the average value（121.56±15.46） nmol/L] was not significant.In the other groups its average values separately were [（417.40±82.31） nmol/L] and [（397.23±92.39） nmol/L] 24 hours af-ter the surgery,compared with before surgery it was significantly elevated,the

关 键 词：阴式 三角形切除术 次全子宫切除术 皮质醇 

分 类 号：R713.42[医药卫生—妇产科学]