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目的探讨子宫肌瘤及子宫腺肌症患者行阴式全子宫切除的临床疗效。方法回顾性分析因子宫肌瘤(A组)和子宫腺肌症(B组)需切除子宫的病例各50例,比较两组患者手术时间、术中出血量、术后并发症、术后肛门排气时间、住院时间等指标的差异。结果两组均无中转开腹的病例,随访期间均无术后并发症发生。当子宫大小如<孕3个月时,A组的术中出血量、手术时间、住院时间和肛门排气时间分别为(152.5±96.6)ml、(84.0±29.0)min、(7.6±1.2)d和(19.3±3.5)h,而B组分别为(150.0±42.9)ml、(93.2±21.5)min、(7.1±1.3)d和(20.8±4.4)h,两组间差异均无统计学意义(P>0.05);当子宫大小≥孕3个月时,A组上述指标分别为(154.8±94.3)ml、(84.2±29.5)min、(8.5±2.3)d和(19.4±3.6)h,而B组分别为(205.0±94.3)ml、(131.3±38.3)min、(9.8±2.7)d和(20.6±4.6)h,两组间的差异有统计学意义(P<0.05)。结论子宫肌瘤和子宫腺肌症阴式全子宫切除术是一种安全、有效、创伤小的术式。但当子宫大小≥孕3个月时,子宫腺肌症行阴式全子宫切除风险较大。
Objective To investigate the clinical efficacy of vaginal hysterectomy in patients with uterine leiomyoma and adenomyosis. Methods A retrospective analysis of 50 patients with uterine uterine fibroids (A group) and adenomyosis (B group) was performed. The operative time, blood loss, postoperative complications, postoperative anal Exhaust time, hospital stay and other indicators of differences. Results There were no cases of laparotomy in both groups. No postoperative complication occurred during follow-up. When the uterus size was <3 months, the blood loss, operation time, hospital stay and anal exhaust time in group A were (152.5 ± 96.6) ml, (84.0 ± 29.0) min and (7.6 ± 1.2) d and (19.3 ± 3.5) h, respectively, while those in group B were (150.0 ± 42.9) ml, (93.2 ± 21.5) min, (7.1 ± 1.3) d and (20.8 ± 4.4) h, respectively (P> 0.05). When the uterus size was 3 months pregnant, the above indexes in group A were (154.8 ± 94.3) ml, (84.2 ± 29.5) min, (8.5 ± 2.3) d and (19.4 ± 3.6) h respectively , While those in group B were (205.0 ± 94.3) ml, (131.3 ± 38.3) min, (9.8 ± 2.7) d and (20.6 ± 4.6) h, respectively. There was significant difference between the two groups (P <0.05). Conclusion Uterine fibroids and adenomyosis vaginal hysterectomy is a safe, effective, small trauma surgery. However, when the uterus ≥ 3 months pregnant, adenomyosis line vaginal hysterectomy greater risk.