阴式子宫切除术后输卵管脱垂的诊治分析

Diagnosis and treatment of fallopian tube prolapse after transvaginal hysterectomy

目的探讨阴式子宫切除术后输卵管脱垂的原因、临床表现及诊断治疗。方法收集2007年1月-2010年11月解放军总医院阴式子宫全切术后发生阴道残端输卵管脱垂6例,发生率0.36%。结果同期手术1 648例患者,手术后发生输卵管脱垂患者中5例为术后放置阴道"T"型引流管,6例均有临床症状,其中4例阴道排液,1例下腹疼痛,1例接触性出血,3例外院多次就诊,误认为肉芽组织。6例均行静脉麻醉下经阴道高位结扎,切除脱垂输卵管,其中5例术后6个月随访均无异常,1例仍在随访中。结论输卵管脱垂一般于子宫全切术后放置阴道"T"管引流造成,临床常易误诊,但经正确的诊断和治疗预后良好。

Objective To study the cause,clinical manifestations,diagnosis and treatment of fallopian tube prolapse（FTP） after vaginal hysterectomy.Methods Six patients who underwent vaginal hysterectomy in our hospital from January 2007 to November 2010 were included in this study.Results The overall incidence of FTP after vaginal hysterectomy was 0.36%.The patients were diagnosed with FTP according to histology and follow-up,and had different symptoms.Pelvic examination revealed a typical prolapsed fimbrial end of the fallopian tube in 2 patients and red granulation tissue in 3 patients,which were excised and cauterized.No FTP recurred during the follow-up.Conclusion FTP is a rare complication of vaginal hysterectomy.The prognosis of patients is good if FTP is correctly diagnosed and treated.