改良腹式子宫切除200例临床总结

Clinical an.alysis of improving abdominal hysterectomy in 200 cases.

目的探讨妇科改良腹式微创开腹手术及皮肤美容缝合在子宫切除中的临床应用。方法采用下腹横形小切口、根据手术情况剔出肌瘤缩减子宫体积、宫颈筋膜内子宫切除以保留主、骶韧带及宫颈筋膜等改良方法。对200例患良性子宫病变行腹部小切口筋膜内子宫切除术作为研究组，同期随机选择200例类似病人采用传统的腹部横切口全子宫切除术作为对照，比较两组的手术时间、手术失血量、术后病率、住院时间、术后排气时间。结果研究组平均手术时间（60．3±10．3）min，手术失血量（84±22．6）ml，术后病率3．5％，住院时间（6．03±4．26）d，术后排气时间（22．8±10．7）h，均明显低于对照组[（92±18．6）min，（198±364）ml，P〈0．001，10．5％，（8．98±6．47）d，（36．2±16．8）h，P〈0．01]。结论改良术式符合微创原则，创伤少、恢复快、保持盆底的解剖结构．是一种安全、经济、容易掌握的妇科开腹手术方法之一，较传统子宫切除术优越，值得在临床推广使用。

Objective To evaluate the clinical application of improving abdominal minimally invasive operation and skin cosmetology suture in hysterectomy. Methods Take hypogastric small transverse skin incisions 、eliminate myoma to reduce uterus 、cervix subfascial resected in hysterectomy to conserving cardinal and uterosacral ligament and other improving ways in 200 case hysterectomy because uterus benign disease. Compared with traditional transverse skin incisions hysterectomy on 200 cases enrolled at random. To analyse the conditions of the operation time, the blood loss, compilation and passing flatus, duration of hospitalization of two groups. Results The operation time, passing flatus time, duration of hospitalization of study group was shorter than contral group ; Blood loss, compilation was obviously less. There was significantly difference（ P 〈 0. 01 ）. Conclusion Improving abdominal hysterectomy is less damage to tissues 、quicker recovery, maintain pelvic floor structure way, it is safe 、inexpensive 、simple 、easy to master , has significant advantages over the traditional hysterectomy , be propagable.