改良式子宫切除术348例分析

Value of Improved Hysterectomy

目的:探讨改良式子宫切除术的临床价值。方法:在耻骨联合上方3～4cm处做横行小切口,长约5～8cm,钝性分离脂肪层,撕拉开腹膜。开腹后不上固定拉钩,不用纱布垫填压肠管,把子宫提拉出盆腔外手术操作,切除子宫后盆腔残端腹膜及腹壁腹膜均不缝合,关腹用可吸收线从切口一侧端连缝筋膜并附带部分脂肪至对侧端,再用同一线返回包埋缝合皮下组织,术后不需拆线。按上述改良方法手术348例,与同期原术式进行比较。结果:改良式手术时间短,术中出血少,术后疼痛轻,排气快,病率低,离床活动早,住院时间短,与对照组相比有显著差异(P<0.01)。结论:改良式子宫切除术效果肯定,优点多,值得临床推广应用。

Objective:To investigate the clinical value of improved hysterectomy. Methods: 1. The big longitudinal incision was changed into a small transverse incision which was about five to eight centimeters long just above the pubis for three to four centimeters,followed by pulling apart the fat layer and peritoneum bluntly. 2. After opening the abdomen, the fixed retractor and gauze were not necessarily used to fill and press down the intestinal canal. Uterus was dragged out of pelvic cavity for operation. 3. After the resection, the peritoneum at the end of uterus was not stitched. 4. Abdominal wall and peritoneum was not stitched when closing the abdomen. Absorbable catgut was used to stitch and connect fat and fascia layer. Then the same catgut was used to embed and sew up the subcutaneous part. Three hundred and forty-eight patients underwent the improved hysterectomy, and the surgery time shortened, the amount of bleeding decreased, the postoperative pain eased, and the speed of exhaust quickened compared with the traditional method. It also took less time for the patients to get out bed for activity. The time confined to hospital shortened. Conclusion:The improved hysterectomy is much easier, and worth spreading.