腹式与阴式全子宫切除术临床分析

Clinical Analysis of Transabdominal and Transvaginal Hysterectomy

目的探讨非脱垂良性病变的子宫施行经腹与经阴道切除术的两种术式的临床效果。方法采用回顾性分析方法,将上海市奉贤区中医医院2005至2008年行全子宫切除术的348例患者,按采用不同的术式分为腹式与阴式两组,对比两组患者的术中和术后情况。结果两组病例均成功完成手术,阴式全子宫切除术的术中出血少、平均手术时间短、术中及近期并发症少、术后发热病率低、肛门排气早、术后镇痛少、离床活动早,但术后平均住院时间与术后随访情况和腹式全子宫切除术相似。结论非脱垂子宫经阴道全子宫切除术是安全有效的,较经腹手术创伤小,恢复快,出血少,切口比较美观。经腹全子宫切除术对于一些肌瘤较大且有附件肿瘤≥5cm或盆腔粘连严重者是较佳的选择方式。

Objective To investigate clinical effects of the non.prolapsed uterus of benign lesions of transabdominal and transvaginal hysterectomy. Methods From 2005 to 2008 in Chinese Medicine Hospitals of Fengxian District, retrospective analysis the 348 cases of patients treated by transabdominal or transvaginal hysterectomy, divided into two groups, and compared two groups of patients with intra-and postoperative. Results The two groups are the successful completion of surgery, vaginal hysterectomy bleeding the less, the average surgical time, intraoperative complications and less postoperative fever rate is low, anal discharge morning, after the town of less pain from the bed as early as, however, the average postoperative hospitalization time and postoperative follow-up and abdominal hysterectomy similar. Conclusion The non-prolapse of the uterus by vaginal hysterectomy is more safe and effective, than the trauma of abdominal surgery, quick recovery, less bleeding, beautiful incision. Abdominal hysterectomy for the large number of fibroid tumors and Annex ≥5cm or severe pelvic adhesions are a better option.