经阴道非脱垂全子宫切除185例临床分析

Clinical Analysis of 185 Patients Undergoing Transvaginal Hysterectomy for Non-prolapsed Uterus

目的分析经阴道非脱垂全子宫切除术的临床特点和适应证范围。方法收集2011年1月至2011年12月期间在常州市武进人民医院因妇科疾病经阴道行全子宫切除术的患者185例,并以同期行腹腔镜全子宫切除术(n=85)和经腹全子宫切除术(n=548)的患者为对照,比较三种术式患者的临床特点和手术适应证范围。结果三种方式全子宫切除术患者在年龄、产次、绝经与否以及剖宫产手术史方面比较差异均无统计学意义(P>0.05)。三组患者在手术适应证和子宫大小的选择方面比较差异也无统计学意义(P>0.05)。经腹、腹腔镜和经阴道同时行附件手术者分别为192例(35.03%)、25例(29.41%)和21例(11.35%),经腹组明显多于经阴道组(P<0.05)。经阴道全子宫切除术组的手术时间和住院时间最短,术中出血量和手术费用最少。结论经阴道非脱垂子宫切除术效果好,并发症少,对于部分子宫较大、有盆腔手术史者也同样适用。

Objective To investigate the clinical features and applications of transvaginal hysterectomy for non-prolapsed uterus from january 2011 to december 2011.Methods One hundred and fourteenth patients undergoing transvaginal hysterectomy for benign gynecological diseases were selected,and patients subjected to laparoscopic hysterectomy（n=85）and transabdom inal hysterectomy（n=548）were served as controls.The clinical features and applications of these three surgical procedures were compared.Results There was no significant difference in age,times of delivery,menopause status and history of cesarean section among three groups（P0.05）,and there was also no significant difference in indications and size of uterus among three groups（P0.05）.Adnexectomy was performed in 192 patients（35.03%）undergoing transabdom inal hysterectomy,25 patients（29.41%）with laparoscopic hysterectomy and 21 patients（11.35%）subjected to transvaginal hysterectomy,and the percent of transabdom inal hysterectomy group was significantly higher than that of transvaginal hysterectomy group（P0.05）.The time of operation and length of hospital stay of transvaginal hysterectomy group were the shortest,and the volume of intraoperative blood loss and cost of treatment of transvaginal hysterectomy group were the least among three groups.Conclusion Ttransvaginal hysterectomy for non-prolapsed uterus may yield favorable outcomes,with less complications and may also be feasible in patients with larger uterus and history of pelvic surgery.