非脱垂子宫阴式切除术200例分析

Clinical analysis of 200 cases of non-prolapse uterus treated by trans-vaginal hysterectomy

目的探讨非脱垂子宫阴式切除的可行性和安全性。方法非脱垂子宫切除患者402例，其中子宫肌瘤305例，子宫腺肌症61例，功能失调性子宫出血36例；299例子宫小于孕10周，103例大于孕10周。分为阴式手术切除和腹式手术切除两组，观察其术中、术后并发症情况。结果阴式组较腹式组术后疼痛、发热率低（P〈0．001），肛门排气时间早（P〈0．001），术后平均住院时间短（P〈0．001），平均手术时间和平均出血量差异不明显（P〉0．05）。结论阴式子宫切除损伤少、术后胃肠功能恢复早、疼痛轻、发热率低、术后平均住院时间短，腹部无瘢痕。若病例选择适当，非脱垂子宫阴式切除是安全可行的。

Objective To investigate the feasibility and safety of transvaginal hysterectomy for non-prolapse uterus. Methods 402 cases of non-prolapse uterus included 305 cases of uterine myoma, 61 cases of adenomyosis and 36 cases of dysfunctional uterine bleeding. Transvaginal hysterectomy and abdominal hysterectomy were conducted for 299 cases 〈 10 gestational weeks and 103 cases 〉 10 gestational weeks,respectively. Results Transvaginal hysterectomy was accompanied with less postoperative pain and fever （P 〈 0. 001 ）, earlier anus exhaustion （P 〈 0. 001 ）,shorter length of postoperative hospital stay （P 〈 0. 001 ）, but the average operation time and the operative bleeding were not significantly different （ P 〉 0.05 ）. Conclusion Compared with abdominal hysterectomy, transvaginal hysterectomy is accompanied with less damage, lighter interference with the abdomen, earlier recovery on indigestion after operation, lighter pain, less fever, shorter length of postoperative hospital stay after operation, no scar. Transvaginal hysterectomy of non-prolapse uterus is safe and feasible in selected patients.