改良非脱垂大子宫经阴道切除术71例临床研究  

Modified transvaginal hysterectomy for non-prolapse and large uterus

作　　者：马铟[1] 任秀萍[1] 

机构地区：[1]安徽省蚌埠市第一人民医院妇产科,233000

出　　处：《淮海医药》2011年第5期397-399,共3页Journal of Huaihai Medicine

摘　　要：目的探讨改良非脱垂大子宫经阴道切除术的可行性和安全性。方法对2009年1月~2010年12月我院71例子宫增大如孕10~18周、活动好、无严重黏连患者施行经阴道子宫切除术（TVH）,与同期33例10~18孕周子宫经腹切除术（TAH）进行对照。结果 71例手术70例成功,1例中转开腹。2组平均手术时间、术中平均出血量比较,子宫≤12孕周者,TVH组显著少于TAH组（P〈0.01）;子宫13~15孕周者,2组差异均无统计学意义（P〉0.05）。子宫16~18孕周者,TVH组平均手术时间长于TAH组（P〈0.05）,术中出血量差异无统计学意义（P〉0.05）。2组术后肛门排气时间、起床活动时间及术后住院时间比较,TVH组均显著短于TAH组（P〈0.01）。结论适当的病例选择加上手术技巧,非脱垂大子宫经阴道切除是安全可行的。手术成功与子宫活动度,肌瘤生长部位及术者经验技术和麻醉效果有关。Objective To study the feasibility and safety of modified transvaginal hysterectomy（TVH） for non-prolapse and large uterus.Methods 71 cases of patients in our hospital from January 2009 to December 2010 underwent TVH,who had enlarged uterus,with the size equivalent to 6~18 gestational weeks and without serious adhesion.Comparison was conducted with 33 cases of 10~18 gestational weeks,who underwent total abdominal hysterectomy（TAH）.Results Of the 71 cases,70 succeeded and 1 case transferred to opening appendectomy.In comparison,those under 12 week gestational weeks in TVH group had significantly less average operation time and intra-operative uterine bleeding than the TAH group（P0.01）.For those of 13~15 gestational weeks,the two groups were not significantly different（P0.05）.For uteri of 16~18 gestational weeks,the average surgery time of the TVH group was longer than that of the TAH group（P 0.05）.The intra-operative bleeding had no statistical difference between the two groups（P0.05）.The time before the post-operative anal exhaust,off-bed activity and the hospitalization for the TVH group was shorter than the TAH group（P0.01）.Conclusion TVH for non-prolapse and large uterus is feasible and safe if cases are carefully selected and surgery is properly conducted.Surgical success may to a large extent be attributed to the uterine mobility,the myoma location,performer＇s experience and the relevant anaesthetic effect.

关 键 词：非脱垂大子宫 子宫切除术 阴道式 

分 类 号：R713.42[医药卫生—妇产科学]