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目的探讨腹腔镜下筋膜内子宫切除术(CISH)后宫颈残端并发症的原因及预防措施。方法改进腹腔镜下筋膜内子宫切除手术方法,将改进前后的病例分为甲乙两组进行比较。结果甲组(改进前)出现5例宫颈囊肿,乙组(改进后)出现1例宫颈囊肿;乙组高频电刀切除组织病理显示:46%患者有宫颈内膜组织残留;乙组术后阴道出血时间、阴道排液时间、宫颈残端愈合时间缩短,与甲组相比差异有显著性。结论宫颈残端潴留囊肿的发生是由于CISH术中宫颈残端残留宫颈活腺体所致,CISH术结合高频电波刀的电圈切除术处理宫颈残端可预防宫颈残端并发症的发生,特别对子宫颈肥大、外口松弛、糜烂较重患者具有较大安全性和可靠性。
Objective To investigate the causes of cervical stump complications after laparoscopic fasciotomy (CISH) and its preventive measures. Methods To improve the method of hysterectomy in laparoscopic fascia, the cases before and after the improvement were divided into two groups. Results A group of cervical cysts was found in group A (before improvement), and one case of cervical cysts in group B (improved). The histopathology of group B showed that 46% of patients had endocervical tissue residuals, and group B Vaginal bleeding time, vaginal discharge time, cervical stump healing time shortened, compared with the group A significant difference. Conclusions Cervical stump retention cyst is caused by residual cervical living gland in CISH. Cervical stump removal by CISH combined with high frequency electric wave knife can prevent the occurrence of cervical stump complication, Especially for cervical hypertrophy, relaxation of the mouth, severe erosion of patients with greater safety and reliability.