非脱垂子宫经阴道切除术式探讨

Study on the surgical management of transvaginal hysterecto my for non -prolapse uterus

为探讨非脱垂子宫经阴道切除不同术式的临床应用价值 ,对 1997年 1月～ 1999年 10月住院有子宫切除指征而无生殖道脱垂 72例患者 ,根据年龄、子宫大小分别行阴式筋膜内子宫切除术 60例和改良阴式子宫切除术 12例 ,平均年龄 50岁 ( 42～ 65岁 )。其中子宫肌瘤 59例 ( 81.94 % ) ,子宫腺肌瘤 8例 ( 11.11% ) ,功血 3例 ( 4.17% ) ,卵巢囊肿 1例 ( 1.39% ) ,慢性宫颈炎 1例 ( 1.39% ) ;子宫活动良好、子宫正常大小 5例 ( 6.94 % ) ,子宫增大 <孕 12周 57例 ( 79.17% ) ,子宫增大 12～ 18周 10例 ( 13 .89% ) ;既往有结扎手术史 8例 ,同时行附件切除 5例。结果显示 :平均手术时间 70min( 60～90min) ,平均出血量 90ml( 80～ 150ml) ,术后 2 0～ 30h肛门排气 ,2 4h下床活动 ,平均住院 7天出院 ( 5～ 8天 )。认为根据患者年龄及子宫大小选择术式 ,微损伤 ,不影响性生活 。

Inordertoestimatetheclinicalvalueoftransvaginalhysterectomyfornon - prolapseofuterus,fromJanuary 1 997toOctober 1 999,72hospitalizedwomenwithhysterectomyindexandnon - prolapseuterusundergonetransvaginalhysterectomy,boththeinterfacialtechnique(60cases)andtheameliorate(1 2cases)forvariousbenigngynecologicallesionswereconsecutivelyincludedinthisstudy.Theirmeanagewas50 (rangefrom 42to65) .Therewere59patients (81 .94% )withhysteromyoma,adenomyomaofuterus 8(1 1 .1 1 % ) ,functionalbleeding 3 (4.1 7% ) ,oophoriticcyst1 (1 .39% ) ,chroniccervicitis1 (1 .39% ) ;5patients(6.94% )withactiveandnormaluterine size,and 57patients (79.1 7% )withuterineenlargedandof <1 2 gestionalweeksize,and 1 0 patients (1 3 .89% )withuterineenlargedof1 2～1 8gestationalweeksize;8patientswithhistoryofligationsurgeryand 5receivedad nexectomy.Resultsshowed :themeanoperativetime 70min (60～ 90min) ,meanamountofbleeding 90ml (80～ 1 50ml) ,rectalexsufflation 2 0～30haftersurgery,activitytime 2 4hoursafteroperation ,hospitalizedaverage 7days(5～ 8days) .Itisconcludedthatthesuccessfulraisedratiooftransvaginalhysterectomyshouldbeaccordingtothe patients’ageanduterinesize,withslightinjury ,effectlessonsexuallife.