非脱垂子宫改良阴式切除术256例分析

Non-Analysis of 256 cases of uterine prolapse improved vaginal hysterectomy

目的:比较非脱垂子宫改良阴式切除术与腹式子宫切除术的手术效果。方法:对256例子宫良性病变经改良阴式切除术(阴式组)的临床资料进行回顾性分析,并与经腹子宫切除术(腹式组)315例进行比较。结果:阴式组手术时间为70.09±20.03min,术中出血量约99.38±45.91m L,术后疼痛用止痛药167例,占65.23%,术后发病78例,发病率30.47%,下床活动时间21.54±6.21h,肛门排气时间15.20±3.21h,住院时间6.23±2.41天,腹式组手术时间93.56±30.20min,术中出血量144.36±60.12m L,术后疼痛用止痛药261例,占82.86%,术后发病101例,发病率32.06%,下床活动时间34.16±9.25h,肛门排气时间25.81±6.83h,住院时间9.34±3.26天。阴式组与腹式组比较,在术后用药、发病率、手术时间、排气时间、住院天数及活动时间等方面存在明显差异(<0.05)。结论:改良阴式子宫切除术,术后患者的恢复明显优于腹式子宫切除术。但要选择恰当地病例,并依赖手术者的手术熟练操作和经验。

Objective： Non-operation effect of uterine prolapse improvedvaginal hysterectomy and abdominal hysterectomy. Methods：In 256 cases of benign uterine diseases treated by improved vaginal hysterectomy（TVH group）were retrospectively analyzed, and compared with transabdominal hysterectomy（TAH group） 315 cases were compared. Results：TVH groupoperation time was 70.09±20.03 min,intraoperative bleeding volume is about 99.38±45.91 m L,accounting for 65.23%of167cases with pain,pain after surgery,78 cases after operation, incidence rate of30.47%,ambulation time 21.54 ±6.21 h 15.20 ±3.21 h, anal exhaust time, hospitalization time 6.23 ±2.41 days abdominal operation time, group 93.56 ±30.20 min, the intraoperative blood loss was144.36 ±60.12 m L, accounting for 82.86% of 261 cases with pain, pain after surgery, 101 cases after operation, incidence rate of 32.06%,ambulation time 34.16 ±9.25 h 25.81 ±6.83 h, anal exhaust time, hospital stay time 9.34 ±3.26 days, TVH group and abdominal group, the operation time, postoperative medication cases, incidence rate, exhaust time, length of hospital stay were significantly different（ P〈0.05）. In the amount of bleeding, complication rate has no obvious difference. Conclusion：Improved vaginal hysterectomy, recovery of the patients after surgery is superior to abdominalhysterectomy. But to the selection of appropriate cases,and rely on the operation skills and experience of operation.