非脱垂子宫经阴道切除术的临床应用

Clinical application of transvaginal hysterectomy for uterus without prolapse

目的 :探讨非脱垂子宫经阴道切除术的优点、适应症、手术要点及并发症。方法 :对 2 0例因子宫肌瘤、功能失调性子宫出血而无子宫脱垂患者 ,行经阴道子宫切除术。术前子宫全部增大但<12孕周 ,既往有手术史者 12例 (6 0 % )。结果 :2 0例非脱垂子宫经阴道切除手术全部成功 ,无术时术后并发症。手术时间 4 5～ 10 0min ,平均 6 0min ;出血量 5 0～ 15 0m1;住院时间 5～ 6d ,平均 5 .2d ;术后均无需使用止痛药。术后 8周随诊 ,阴道残端愈合良好。结论 :非脱垂子宫经阴道切除手术时间短 ,出血量少 ,腹部无瘢痕 ,切口疼痛轻 ,恢复快。对于既往有盆腔手术史者 ,并不是非脱垂子宫经阴道切除术的禁忌症。

Objective: To assess the advantage, indications, surgical management and complications of transvaginal hysterectomy for uterine without prolapse. Methods: 20 cases of transvaginal hysterectomy for uterine without prolapse were performed. The uteri with benign lesions enlarged, but < 12 weeks of pregnancy. 12 patients (60%) had previous laparotomy.Results: All patients were operated successfully without intra-and post-operation conplications. The mean operating time was 60 min with a range 45～100 min. The amout of blood loss during operationranged 50～150ml. Post-operative hospital stay averaged 5.2 days (range 5～6 days). The vaginal stumps healed completely 8 weeks after the operation. Conclusion: Transvaginal hysterectomy for uterine without prolapse was associated with remarkable advantages: shorter operating time and hospital stay, less amout of blood loss during operation, no abdominal scar, fewer complication, less discomfort and quicker recovery. Previous operation should no longer be considered as contraindication of transvaginal hysterectomy.