顺行式阴式子宫次全切除术的临床可行性研究  

Clinic feasibility of anterograde transvaginal subtotal hysterectomy

作　　者：李子军[1] 郑雅琴[1] 徐仙凤 刘敏[1] LI Zi-jun;ZHENG Ya-qin;XU Xian-feng;LIU Min(Hospital of Zhejiang Quhua,Zhejiang Quzhou 324004,China)

机构地区：[1]浙江省浙江衢化医院,浙江衢州324004

出　　处：《中国妇幼健康研究》2018年第9期1200-1204,共5页Chinese Journal of Woman and Child Health Research

基　　金：衢州市科技局市级科研资助项目(编号2015090)

摘　　要：目的探讨非脱垂、良性疾病的子宫实施保留宫颈的顺行式阴式子宫次全切除术的临床可行性。方法选取浙江省浙江衢化医院自2014年9月至2017年9月住院患者对要求保留宫颈的60例非脱垂、良性病变的子宫实施保留宫颈的顺行式阴式子宫次全切除术,并选择既往5年中该院行腹腔镜下子宫次全切除术患者40例为对照组,比较两组患者在年龄、平均手术时间、术中出血量、术后肛门排气恢复时间、术后并发症发生率、平均住院时间及平均住院费用方面的差异。结果 60例非脱垂子宫均完成顺行式阴式手术,两组在年龄(t=0.642,P>0.05)、手术时间(t=-2.938,P>0.05)、平均住院时间(t=-0.689,P>0.05)及术后并发症发生率(χ2=0.154,P>0.05)方面均无显著性差异,而顺行式阴式子宫次全切除术在术中出血量明显增多(t=3.585,P<0.05),肛门排气时间明显缩短(t=-7.706,P<0.05),平均住院费用明显降低(t=-21.372,P<0.05)。结论对于非脱垂、良性病变子宫(小于12孕周的子宫),严格掌握适应症及手术技巧后实施顺行式阴式子宫次全切除术是相对安全可行的,具有经济、微创的优点。Objective To evaluate the clinical feasibility of anterograde transvaginal subtotal hysterectomy（ATVSH）in nonprolapsed uterus and benign lesion of uterine cervix.Methods Clinical data of 60 cases of anterograde transvaginal subtotal hysterectomy（ATVSH）in Hospital of Zhejiang Quhua from September 2014 to September 2017 and 40 cases of laparoscopic subtotal hysterectomy（LSH）during the past five years were collected for the analysis of patients＇ age,the operation time,intraoperative bleeding volume,postoperative anal exsufflation time,postoperative morbidity,average length of hospital stay and average hospital maintenance fee.Results Sixty cases of non-prolapsed uterus performed ATVSH.There were no significant differences in age（t=0.642,P〉0.05）,operation time（t=-2.938,P〉0.05）,average length of hospital stay（t=-0.689,P〉0.05）and postoperative morbidity（χ2=0.154,P〉0.05）.Compared with LSH,ATVSH had significantly higher intraoperative bleeding volume（t=3.585,P〈0.05）,earlier postoperative anal exsufflation（t=-7.706,P〈0.05）and lower average hospital maintenance fee（t=-21.372,P〈0.05）.Conclusion ATVSH is minimally invasive,safe and feasible operation approach and method for cases of non-prolapsed uterus and benign lesion when indications and operation technique are controlled.

关 键 词：非脱垂子宫 顺行式子宫次全切除术 腹腔镜下子宫次全切除术 可行性 

分 类 号：R713.42[医药卫生—妇产科学]