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本文综合报道半腹膜外子宫切除术622例(其中吉林妇产医院421例,大连医学院附属二院201例)。本术式适用于子宫肌瘤,功能失调性子宫出血、滋养细胞肿瘤等,而且要求子宫不超过新生儿头大、盆腔内无严重粘连者。手术关键在于正确分离和寻找宫颈前膀胱腹膜反折,在其上切一小口,由此将子宫由腹腔移至腹膜囊外,之后将腹膜囊关闭。切除子宫的全部操作皆在腹膜外进行。本术式对腹腔脏器基本上无干扰。本组资料表明:其术后病率及术后腹胀明显低于腹膜内子宫切除术(P<0.05),术后胃肠功能恢复快,开始排气时间平均的术后12～24小时,明显早于腹膜内术式。
This article comprehensively reported 622 cases of semi-extraperitoneal hysterectomy (including 421 cases of Jilin Maternity Hospital and 201 cases of Second Affiliated Hospital of Dalian Medical College). This technique is suitable for uterine fibroids, dysfunctional uterine bleeding, trophoblastic tumors, etc., but also requires the uterus does not exceed the neonatal head large pelvic no serious adhesion. The key to the surgery is to properly separate and look for the pre-cervical bladder peritoneal reflex, cutting a small hole in it, thereby moving the uterus from the abdominal cavity to the peritoneal capsule and then closing the peritoneal capsule. All resections of the uterus are performed extraperitoneally. The operation of the abdominal organs basically no interference. The data show that: the postoperative morbidity and postoperative abdominal distension was significantly lower than intraperitoneal hysterectomy (P <0.05), postoperative gastrointestinal function recovered quickly, the average time to start the exhaust 12 to 24 hours after surgery, significantly As early as intraperitoneal surgery.