非脱垂子宫阴式手术37例临床分析

    Vaginal surgery for 37 cases with no prolapsed uterus

    • 摘要: 目的:探讨非脱垂子宫阴式手术方法及临床应用价值。方法:选取非脱垂子宫阴式手术37例,子宫为正常大小至14孕周。术式为子宫全切6例(其中子宫碎解及对半切开后再切除各1例),次全切12例(其中肌瘤剔除后再切除11例),肌瘤剔除术19例,并对手术方法、要点、适应证及禁忌证等加以讨论。结果:37例经阴道手术成功,术后病理为子宫肌瘤33例,子宫腺肌病3例,子宫颈上皮内瘤变3级1例,术后并发症2例,均治愈。结论:非脱垂子宫阴式手术适用于子宫活动度良好、无明显盆腹腔粘连、阴道较宽松、有明确手术指征的患者,且需排除盆腔子宫内膜异位症及生殖器恶性肿瘤;该术式具有损伤小、恢复快、住院时间短、腹壁无瘢痕、费用低等优点,适用于各级医院。

       

      Abstract: Objective: To explore the value of vaginal surgery for patients with no prolapsed uterus.Methods: Thirty-seven patients with no prolapsed uterus were included in the study.The sizes of the uterus were from normal to 14 gestational weeks.Hysterectomy was performed in six cases(including 1 uterine morcellation and 1 semi-open before the resection),hypo-hysterectomy in 12 cases and myomectomy in 19 cases.The surgical procedures,key points,indications and contraindications were discussed.Results: The operation was successful in all the 37 cases.The postoperative pathology proved that 33 cases were uterine fibroids,3 cases adenomyosis and 1 was cervical intraepithelial neoplasia of grade-3.Two cases of postoperative complications were cured.Conclusions: Vaginal surgery is adapt to patients with good uterus activity,no obvious abdominal adhesions,relaxed vagina and clear surgical indications;Pelvic endometriosis and genital cancer should also be excluded.The procedure has the advantages of less lesion,quicker recovery,shorter hospital stay,no abdominal scar and low cost.It can be applied to hospitals of all levels.

       

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