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目的:探讨宫颈锥切术后行子宫切除术的最佳时机。方法:选择2008至2015年汕头市中心医院收治的宫颈上皮内瘤变(CIN)Ⅱ-Ⅲ及宫颈原位癌患者为研究对象,共90例,所有患者均行宫颈锥切术后再次行子宫切除术。根据2次手术间隔时间进行分组,分为锥切后72 h内、锥切后72 h~1周、锥切后6周3组,各30例,A组在宫颈锥切术后6周行子宫切除术,B组在宫颈锥切后72 h内行子宫切除术,C组在锥切后72 h~1周内行子宫切除术,手术结束后,对比分析3组患者的手术时间、术中出血量、抗生素使用时间、住院时间及并发症发生率。结果:3组的手术时间比较,差异均无统计学意义(P>0.05);A组的并发症发生率为3.33%,B组的并发症发生率为4.67%,C组的并发症发生率为40.00%,差异具有统计学意义(P<0.05);A组术中出血量、抗生素使用时间及住院时间均低于B组和C组,差异具有统计学意义(P<0.05)。结论:宫颈锥切手术结束6周以后行子宫切除术较为合理,可有效减少患者的术中出血量、并发症情况、用药时间及住院时间,进一步改善患者的预后。
Objective: To investigate the best timing of hysterectomy after cervical conization. Methods: Cervical intraepithelial neoplasia (CIN) Ⅱ-Ⅲ and cervical carcinoma in situ were recruited from Shantou Central Hospital from 2008 to 2015. A total of 90 patients were enrolled in this study. All patients underwent cervical conization, cut. The patients were divided into two groups according to the operation time: 72 hours after conization, 72 hours to 1 week after conization, 3 cases after conical cutting 6 weeks, 30 cases in each group. Hysterectomy, group B in hysterectomy within 72 h after conization of the cervix, C group 72 h to 1 week after conization, hysterectomy, after the operation, comparative analysis of the three groups of patients operating time, intraoperative bleeding Volume, antibiotic use time, length of hospital stay and complication rate. Results: There was no significant difference in operative time between the three groups (P> 0.05). The incidence of complications in group A was 3.33%, the incidence of complications in group B was 4.67%, and the complication rate in group C The difference was statistically significant (P <0.05). The blood loss, antibiotic use time and hospital stay in group A were lower than those in group B and C (P <0.05). CONCLUSION: Hysterectomy is more reasonable after 6 weeks of conization. It can effectively reduce the amount of intraoperative blood loss, complications, medication duration and hospital stay, and further improve the prognosis of patients.