论文部分内容阅读
目的 :对 2 2 2例非子宫脱垂患者行经阴道子宫切除术 (TVH)分析 ,进一步探讨TVH的适应证 ,评价其临床应用价值。方法 :对各种有子宫切除指征的非脱垂子宫患者 ,排除子宫不活动 ,盆腔明显粘连及阴道狭窄者 ,术前进行子宫活动度、下移度检查来选择病例 ,采用TVH术式 ,患者平均年龄 45岁 ,输卵管结扎史 1 1 6例 ,子宫下段剖宫产术后 1例 ,阑尾炎术后 1例。子宫正常大小 42例 ,子宫增大 ,小于 1 2孕周 1 44例 ,大于孕 1 2周 36例。结果 :2 2 2例TVH手术全部成功 ,占同期子宫切除总数的 81 .6% ,同时行阴道前壁或后壁修补 1 0例 ,附件切除 2 2例 ,平均手术时间 62min( 2 0min～ 3h) ,出血量 1 44 .6mL( 2 0mL～30 0mL) ,平均住院 9d。结论 :对子宫良性病变需行子宫切除者 ,TVH可取代大多数的开腹手术 ,手术适应证较界定范围有所扩大 ,并有微创 ,术式简易的优点。
Objective: To investigate 202 cases of non-uterine prolapse by vaginal hysterectomy (TVH) analysis to further explore the TVH indications and evaluate its clinical value. Methods: All kinds of uterine indications of non-prolapsed uterine patients, excluding uterine inactivity, pelvic obvious adhesions and vaginal stenosis, preoperative uterine motion, the degree of movement under the check to select the case, the use of TVH surgery, The average age of patients was 45 years old, tubal ligation history 116 cases, 1 case of lower uterine segment after cesarean section, 1 case of appendicitis. Normal size of the uterus in 42 cases, the uterus increased, less than 1 2 gestational weeks 1 44 cases, greater than 12 weeks pregnant 36 cases. Results: Twenty-two cases of TVH were successful, accounting for 81.6% of the total number of hysterectomy in the same period. Meanwhile, 10 cases were repaired by anterior vaginal wall or posterior wall, and 22 cases were removed. The average operation time was 62 minutes (20 minutes to 3 hours ), The amount of bleeding was 44.6mL (20mL-30OmL), and the average hospitalization was 9d. Conclusion: For patients with uterine benign lesions who need hysterectomy, TVH can replace most of the open surgery, surgical indications more than the defined range has been expanded, and minimally invasive, simple surgical advantages.