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目的 探讨暴露子宫动脉阴式子宫切除术 (TVH)优点、手术要点及临床应用价值。方法 对 80例因子宫肌瘤、子宫肌腺症、功能性子宫出血及绝经后出血经诊刮排除生殖恶性肿瘤行暴露子宫动脉 TVH。术前子宫正常大小 12例 (15 % ) ,子宫增大但小于 12周 4 5例 (5 6 .2 % ) ,子宫大于 12周 2 3例 (2 9.8% )。既往有手术者 10例(12 .5 % ) ,同时行附件切除术 5例 (6 .3% )。对子宫大于 14周采用子宫对半切开法、子宫分碎法及肌瘤切除法。结果 手术时间 35～ 75分钟 ,平均 5 0分钟 ;出血平均 95 ml;术后住院时间 3～ 7天。结论 暴露子宫动脉法 TVH手术时间短 ,出血量少 ,有效避免术中术后并症的发生 ,缩短住院时间。
Objective To explore the advantages, main points of surgery and clinical value of exposing uterine artery vaginal hysterectomy (TVH). Methods 80 patients with uterine fibroids, adenomyosis, functional uterine bleeding and postmenopausal bleeding were treated by curettage to remove genital malignancies to expose uterine artery TVH. Preoperative uterine normal size in 12 cases (15%), uterus increased but less than 12 weeks 45 cases (56.2%), the uterus more than 12 weeks in 23 cases (2 9.8%). There were 10 cases (12.5%) with previous surgery and 5 cases (6.3%) with concurrent resection. On the uterus for more than 14 weeks using half-incision of the uterus, uterine fragmentation and myomectomy. Results The operation time was 35 to 75 minutes, with an average of 50 minutes. The mean bleeding volume was 95 ml. The postoperative hospital stay was 3 to 7 days. Conclusion The exposure of uterine artery TVH operation time is short, less bleeding, effectively prevent postoperative complications and shorten the hospital stay.