腹腔镜下全子宫切除术后阴道残端裂开的相关因素研究

Research on the related factors of vaginal stump dehiscence after laparoscopic hysterectomy

目的探讨腹腔镜下全子宫切除术后阴道残端裂开的相关因素。方法回顾性分析2015年1月-2019年12月该院1151例行腹腔镜下全子宫切除术患者的临床资料,采用多因素Logistic回归分析发生阴道残端裂开的高危因素。结果术后发生阴道残端裂开8例,发生率为0.70%,单因素分析结果提示:术前血红蛋白值、阴道残端缝合方式及术后首次性生活时间与腹腔镜下全子宫切除术后阴道残端裂开相关(P<0.05);多因素Logistic回归分析结果提示:术前血红蛋白值<90 g/L和术后首次性生活时间距离手术<3个月是腹腔镜下全子宫切除术后阴道残端裂开的独立危险因素(P<0.05)。结论术前纠正血红蛋白≥90 g/L和术后首次性生活时间距离手术≥3个月可以减少腹腔镜下全子宫切除术后阴道残端裂开的发生。

Objective To explore the related factors of vaginal stump dehiscence after laparoscopic hysterectomy.Methods The clinical data of 1151 patients underwent laparoscopic hysterectoing from January 2015 to December 2019 were analyzed retrospectively,and multivariate Logistic regression was used to analyze the high-risk factors of vaginal stump dehiscence.Results There were 8 cases with vaginal stump dehiscence after operation,with the incidence of 0.70%.Univariate analysis showed that preoperative hemoglobin value,vaginal stump suture method and postoperative first sexual life time were related to vaginal stump dehiscence after laparoscopic hysterectomy(P<0.05).Multivariate Logistic regression analysis showed that preoperative hemoglobin value<90 g/L and the time interval between postoperative first sexual life and operation<3 months were independent risk factors for vaginal stump dehiscence after laparoscopic hysterectomy(P<0.05).Conclusion Postoperative hemoglobin correction≥90 g/L and the time interval between postoperative first sexual life and operation≥3 months can reduce the occurrence of vaginal stump dehiscence after laparoscopic hysterectomy.