全子宫切除术后阴道残端并发症相关因素分析

Related factors analysis of vaginal stump complications following hysterectomy

目的 探讨全子宫切除术后阴道残端并发症的相关因素.方法 采用回顾性研究方法,将延安市中医医院妇产科2008年1月～2010年1月共20例全子宫切除术后发生阴道残端出血或感染、愈合不良、息肉患者做为研究组,与同期40例全子宫切除术后无阴道残端并发症患者的相关资料进行对比,分析相关因素与阴道残端并发症的关系.结果 研究组与对照组阴道残端并发症相关因素进行比较,其中贫血（χ2=5.21）、下生殖道炎症（χ2=17.06）、手术途径（χ2=4.43）、术前阴道准备时间（t=2.14）差异均有统计学意义（均P〈0.05）,而内科合并症（如高血压、糖尿病）与阴道残端并发症关系不大（χ2=1.80,P〉0.05）.结论 在行全子宫切除术时应针对各相关因素,充分做好术前准备,及时纠正贫血和感染,选择适合的手术途径,可有效地降低术后阴道残端并发症的发生.

Objective To explore the factors associated with vaginal stump complications following hysterectomy. Methods 20 cases with vaginal stump complications such as hemorrhage or infection, poor healing, or polyps following hysterectomy in Yan＇ an traditional Chinese medicine hospital from January 2008 to January 2010 were selected in study group, and 40 cases with hysterectomy without any vaginal stump complication at the same period were selected in control group. A retrospective study was made to analyze the relationship between related factors and vaginal stump complications. Results The related factors including anemia （χ2 = 5.21 ）, lower genital tract inflammation （χ2 = 17.06 ）, operative approach （χ2 = 4.43 ） and preoperative vaginal preparation time （ t = 2.14 ） of study group were significantly different from those of control group （ all P 〈 0. 05 ）. However, medical complications （ such as hypertension, diabetes） had no close association with vaginal stump complication （χ2 = 1.80, P 〉 0.05 ）. Conclusion Adequate preoperative preparation, timely correction of anemia and infection and selecting suitable operation approach can reduce vaginal stump complications following hysterectomy effectively.