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我院自1987年以来开展了腹膜外子宫切除术30例,收到了良好效果。现分析如下。 资 料 与 方 法 一、一般资料:本文30例腹膜外子宫切除术中,子宫肌瘤18例,子宫腺肌症4例,子宫粘膜下肌瘤3例,子宫内膜增殖症3例,子宫肥大症1例,宫内膜息肉1例。年龄最大52岁,最小38岁,40～50岁27例占90％。合并症以不同程度贫血最多共10例占33％,其次合并卵巢瘤5例,卵巢巧克力囊肿2例,胆囊结石1例。 二、手术方法 1.术前留置导尿管并钳闭,使膀胱适度充盈以利分离,并加用美蓝盐水100ml充盈膀胱,便于及时发现膀胱损伤。2.于耻联上2cm作弧形横切口,切开腹壁,分离腹直肌,暴露膀胱前区。3.推开腹横筋膜后,在膀胱顶部下2cm左右,于膀胱筋膜用一尖头中弯血管钳挑开一小口,每扒开一层即用手指插入其内向两侧下方弧形钝性分离扩大之,经上法处理2
Our hospital since 1987 carried out extraperitoneal hysterectomy in 30 cases, received good results. Analysis is as follows. Materials and Methods First, the general information: This article 30 cases of extraperitoneal hysterectomy, uterine fibroids in 18 cases, adenomyosis in 4 cases, 3 cases of uterine submucosal fibroids, endometrial hyperplasia in 3 cases, uterine hypertrophy 1 case, 1 case of endometrial polyps. The oldest 52 years old, the youngest 38 years old, 40 to 50 years old 27 cases accounted for 90%. Anemia at most 10 cases accounted for 33%, followed by merger of 5 cases of ovarian tumor, 2 cases of ovarian chocolate cyst and 1 case of gallstone. Second, the surgical methods 1. Preoperative catheterization and clamp closed, so that the appropriate filling of the bladder to facilitate separation, and add the United States Blue 100ml filling the bladder, easy to timely detection of bladder injury. 2. Shame on the 2cm arc curved transverse incision, incision abdominal wall, separating the rectus abdominis, exposing the anterior bladder area. 3. Open the transverse fascia, the bladder at the top of about 2cm, in the fascia of the bladder using a pointed curved vascular forceps to open a small mouth, each of a single layer of finger that is inserted into both sides of its downward inward curved blunt The separation of sexual expansion, the law on the handling 2