宫颈残端切除18例临床分析  

Removal of the Retained Cervical Stump:Clinical Analysis of 18 Cases

作　　者：杨秀萍[1] 

机构地区：[1]江苏省大丰市人民医院妇产科,江苏大丰224100

出　　处：《临床医学工程》2010年第9期61-62,共2页Clinical Medicine & Engineering

摘　　要：目的探讨子宫次全切除术后因宫颈病变及因盆腔疾患需行宫颈残端切除的原因,宫颈残端病变的临床表现、治疗方法和预防措施。方法回顾性分析2004年1月至2010年1月本院收治的18例行宫颈残端切除的患者的临床资料。结果 18例行宫颈残端切除的病因中,2例为宫颈残端平滑肌瘤复发,3例为宫颈残端鳞癌,2例为宫颈子宫内膜异位症,5为宫颈重度不典型增生,6例为卵巢肿瘤合并重度宫颈糜烂。主要表现为腹胀、尿潴留、阴道不规则流血、阴道流液和接触性出血、盆腔包块。治疗以手术为主,18例中1例发生膀胱损伤,1例因肠管广泛粘连于腹壁而出现小肠损伤,均于术中及时发现并予修补。18例均如期拆线出院。结论应严格掌握子宫次全切除术的指征,术前、术中不漏诊子宫、宫颈恶性肿瘤,术中预防副损伤,术后应严密随访,及时发现处理宫颈残端病变。Objective The purpose of this study was to explore the cause of the removal of retained cervical stump because of the pathological changes of retained cervical stump or cavitas pelvis after previous subtotal hysterectomy.Methods This was a retrospective review of 18 trachelectomy patients at Dafeng Hospital between January 2004 and January 2010.Results Of 18 patients with a history of sbtotal hysterectomy,2 patients subsequently required trachelectomy because of recurrence of leiomyoma,3 because of squamous carcinoma,2 because of endometriosis,5 because of cancer in situ and 6 because of tumor of the ovary associated with serious cervical erosion.The main clinical manifestations were abdominal distension,uroschesis,irregular vaginal bleeding,vaginal exudate and contact bleeding,pelvic mass.During operation,one patient＇s bladder was injured and another patient＇s small intestine was injured because of the extensive adherence between small intestine and abdominal wall.They were all discovered during the process of operation and then repaired successfully.All patients recovered and discharged as scheduled.Conclusion The operative indications of supracervical hysterectomy must be mastered strictly：the diagnosis of malignant tumor located in the uterus and cervix should not be missed before and during operation;the secondary injury should be prevented during operation;closed follow-up should be performed after operation and as a result the pathological changes of retained cervical stump could be discovered and treated promptly.

关 键 词：子宫次全切除术 宫颈残端切除术 宫颈残端癌 

分 类 号：R737.33[医药卫生—肿瘤]