小切口辅助阴式子宫切除术150例临床研究  

Small-incision Assisted Transvaginal Hysterectomy:Report of 150 Cases

作　　者：张青[1] 李莉 曹云桂[1] 甘晓卫[1] 李芳[1] 唐江萍[1] 钟小芳[1] 高永梅[1] 

机构地区：[1]上海市嘉定区妇幼保健院,上海201800 [2]上海市嘉定区南翔医院妇科,上海201800

出　　处：《中国微创外科杂志》2011年第10期891-892,共2页Chinese Journal of Minimally Invasive Surgery

基　　金：上海市嘉定区科委课题(2007);编号:JKK027

摘　　要：目的探讨小切口辅助阴式子宫切除术的安全性和临床价值。方法 2007年7月～2009年12月对79例子宫肌瘤,41例子宫肌腺病,7例子宫肌瘤合并子宫肌腺病,15例子宫脱垂合并阴道前后壁膨出,8例子宫内膜息肉及不典型增生行小切口辅助阴式子宫切除术,在腹部做一3～4 cm小切口,经腹分离盆腔粘连或探查并处理附件、分离膀胱子宫腹膜反折,再行阴式手术。结果术中出血量为(196.9±40.6)ml,切除子宫称重(220.1±103.0)g;手术时间(130.5±27.5)min;肠功能恢复时间(30.5±9.9)h;住院(13.5±2.1)d。123例随访6个月,术后1个月1例阴道残端愈合欠佳,反复少量阴道出血,氨甲环酸口服止血,无痛碘纱布压迫24 h后再更换纱布,治疗1周后治愈,其余患者无并发症发生。结论小切口辅助阴式子宫切除术简单、易学、切口小、疼痛轻、并发症少。Objective To explore the safety and clinical efficacy of small-incision assisted vaginal hysterectomy. MethodsWe analyzed the medical records of 79 cases of uterine fibroids,41 cases of adenomyosis,7 cases of uterine fibroids adenomyosis,15 cases of combined anterior and posterior vaginal prolapse uterine prolapse,and 8 cases of endometrial polyps and atypical endometrial hyperplasia,who received small-incision assisted transvaginal hysterectomy between July 2007 and December 2009.On the abdomen we made a 3-to 4-cm small incision to loosen transabdominal pelvic adhesions or explore or separate the accessories and vesico-uterine peritoneal reflexion,so that to perform transvaginal hysterectomy safely. Results The operation was finished in a mean of（130.5±27.5） min with estimated blood loss of（196.9±40.6） ml.The mean weight of the removed uterus was（220.1±103.0） g.After the operation the bowel function recovered in（30.5±9.9） h,and the mean hospital stay of the patients was（13.5±2.1） d.Follow-up for 6 months was achieved in 123 patients,during which we found one patient had poorly healed vaginal stump with mild vaginal bleeding and thus prescribed tranexamic acid and compression hemostasis with iodine dressings changed every 24 hours for one week.Conclusion Small-incision assisted vaginal hysterectomyis simple and easy to learn with less trauma and complications to patients.

关 键 词：小切口 阴式子宫切除术 

分 类 号：R713.42[医药卫生—妇产科学]