下腹小横切口次全子宫切除术56例临床分析

Clinical analysis of 56 cases of hypo-heterectomy by lower-abdominal transverse incision

目的 观察下腹小横切口行改良后次全子宫切除手术的治疗效果。方法 56 例采用改良手术方式进行手术为改良组,66例采用常规手术方式进行手术为常规组。采用改良的手术方法,能够在小切口下完成手术:(1) 离断一侧附件或者子宫血管后,断端分别缝扎,不保留血管钳钳夹残端,利于小切口操作;(2)离断两侧附件后,用 S拉钩将子宫体拉向上腹,暴露并剪开膀胱子宫反折腹膜;(3)子宫血管直接缝扎,然后与子宫一起离断而不单独离断。结果 改良后的次全子宫切除手术有如下优点:(1)采用下腹小的横切口,改良组的切口长度小于常规组,差异显著(P<0.05);手术切口小,外形美观; 满足了患者对手术切口美观的要求;(2)改良组手术时间较常规组短,差异显著(P<0.05)。术中出血量少于常规组,差异无显著性(P>0.05);(3)术后调查表明,患者对手术方式都非常满意。结论 采用改良方法进行子宫次全切除手术,对有适应症的子宫肌瘤和子宫腺肌病患者有很好的治疗效果,提高了患者的身心健康水平。

Objective To study the therapeutic effect of hypo-heterectomy by lower-abdominal transverse incision on uterine.Methods Fifty-six cases of patients were divided into reform group, and 66 cases of patients usual group. The reform operation can be performed within short incision. It includes: (1) The incised connect tissues closing uterine were sewed instead of clipped;(2) The uterine body was pulled to upper abdominal cavity, which would help bladder-uterus peritoneum to be displayed;(3) The uterine blood vessels were sewed directly, and incised with uterine body.Results The reformed operation has several advantages: (1) The incision lengths of reform group were shorter than those of usual group significantly (P<0.05), and all operations can be performed.(2) The operation times of reform group were shorter than those of usual group significantly (P<0.05),and the bleeding volumes were the same(P>0.05);(3) The investigation showed that the patients were satisfactory with their performed operations. Conclusion The reformed operation of hypo-heteretomy has good therapeutic effect for patients suffered from uterine leiomyoma and adenomyosis.