简介:摘要目的探讨非脱垂子宫经阴道全子宫切除术与经腹全子宫切除术的临床效果。方法选择2013年9月至20014年12月在我院妇科住院的非脱垂子宫患者,采用阴式子宫全切术病例49例为阴式组,并与常规开腹子宫全切术病例50例为腹式组,比较两种术式的手术并发症、手术时间、术中出血量、术后病率、术后排气时间、术后疼痛,住院天数。结果阴式组的手术时间与腹式组相比差异无显著意义(P>0.05),阴式组术中出血、术后排气时间,术后疼痛轻,住院天数明显少于腹式手术组,差异有显著意义(P<0.05P<0.01)。结论阴式子宫全切术并发症少、术中出血少,手术时间短、肠道干扰少、术后疼痛轻、术后发热少,术后恢复快、手术创伤小,符合微创原则,是一种安全、有效的子宫切除术式,值得临床推广。
简介:摘要目的通过对我院2007年1月——2012年12月因全子宫切除术后输卵管经阴道残端脱垂的10例病人治疗情况进行回顾性分析,运用病例比较的方法,发现10例中有1例输卵管从阴道残端正中间脱垂较大,经用丝线结扎根部,1周后自行脱落,残端重新愈合;1例丝线结扎失败后,直接将输卵管送入腹腔后重新缝合阴道残端正中间引流口而治愈;其余8例全部在手术室行腰硬联合麻醉下经阴道还纳输卵管后重新修剪、缝合阴道残端治愈。结果表明全子宫切除术后输卵管脱垂的发生率不高,但因临床认识不足,处理有一定困难,大部分病人需再次手术还纳输卵管后重新缝合阴道残端达到治愈目的,治疗应实行个体化原则。
简介:摘要盆腔器官脱垂(POP)是施行子宫切除术的常见原因之一,但子宫切除术也可能是未来发生POP的原因。本文主要阐述子宫切除术与POP之间的关系、子宫切除术后是否行预防性或治疗性阴道顶端悬吊术(ASP)、盆底修补手术是否同时行子宫切除术等热点问题。子宫切除术与POP,从盆底解剖结构到术式选择及治疗预后有着密切而复杂的关系。因非POP良性疾病适应证切除子宫而无预防阴道顶端脱垂手段的妇女未来可能有发生POP的风险;而因POP适应证切除子宫的妇女,大多数情况下阴道顶端支撑结构已经受损,脱垂发生风险显著增加。因此多个指南建议子宫切除术同时行预防性或治疗性ASP以减少术后阴道顶端脱垂的发生。
简介:[摘要]目的:研究盆底重建联合全子宫切除术治疗重度子宫脱垂的治疗效果。方法:将我院于2018年12月~2020年1月收治的120例重度子宫脱垂患者纳入研究范围,根据随机数表法将其分为观察组(60例)和对照组(60例);对照组给予硬膜外麻醉,行全子宫切除术结合阴道前后壁修补术治疗,观察组在硬膜外麻醉后行盆底重建联合全子宫切除术治疗。对比两组盆底功能影响评分、盆底功能障碍评分、性功能、并发症发生率。结果:观察组盆底功能影响评分明显低于对照组,观察组术后盆底功能对排尿、结直肠肛门影响较小;观察组盆底功能障碍评分明显低于对照组,观察组术后盆底功能障碍改善较为显著;观察组患者性功能评分优于对照组(P
简介:摘要目的对Ⅲ度子宫脱垂合并阴道膨出患者行经阴道全子宫全阴道切除术进行治疗的效果进行研究分析。方法选取2016年5月至2018年1月来本院诊治的Ⅲ度子宫脱垂合并阴道膨出患者40例进行分组研究,并随机将40例患者分为研究组和对照组,每组20例,其中研究组行经阴道全子宫全阴道切除术治疗,对照组行经阴道全子宫切除术以及修补术联合治疗。观察两组患者治疗效果以及术后并发症发生情况。结果手术治疗后,研究组的治疗效果显著优于对照组,包括手术时间、排气时间、出血量以及住院时间均低于对照组,差异显著,P<0.05有统计学意义;研究组患者术后并发症发生率为0.0%,而对照组术后并发症发生率为30%,组间差异显著,P<0.05有统计学意义。结论对Ⅲ度子宫脱垂合并阴道膨出患者行经阴道全子宫全阴道切除术进行治疗的效果显著,并发症发生率低,值得临床推广应用。
简介:目的探讨非脱垂阴式大子宫切除术的方法和经验。方法在2002年3月至2005年9月对56例子宫增大如6~18孕周、活动、估计无粘连的子宫肌瘤、肌腺病患者,行阴式子宫切除术(TVH),与同期指征相近的经腹全子宫切除术(TAH)45例进行分析比较。手术主要方法是:从阴道前后穹窿切口,利用减小子宫体积的手术方法包括子宫对半切开、子宫肌瘤切除、子宫分碎、子宫肌瘤剔除术。结果56例经阴道手术成功,平均子宫重量为367g(155~763g),无术中、术后并发症,出血量、手术时间、肛门排气时间、术后下床活动时间及住院时间和伤口疼痛程度均小于TAH组,两组差异有统计学意义(P〈0.05)。结论经阴道切除较大的子宫是有效和安全的手术。
简介:摘要:目的:分析探讨非脱垂子宫经阴道切除术的临床应用效果及价值。方法:以我院在 2016 年 10 月 -2018 年 1 月期间所收治的 50 例行 非脱垂子宫经阴道切除术患者作为研究组,同期选取 50 例行 非脱垂子宫经腹切除术患者作为对照组,然后观察并比较两组患者手术时间、术中的出血量以及术后相关指标情况。结果:研究组患者均手术成功,且患者手术时间、术中出血量、术后肛门的排气时间、术后的下床时间以及术后的住院时间均比对照组患者明显偏少,对比差异明显, P < 0.05 ,具有统计学意义。 结论:与非脱垂子宫经腹切除术相比,经阴道切除术的操作简便,且术中出血量少、术后患者康复较快,因而具有广阔的临床应用与推广价值。
简介: [摘要 ]目的:研究Ⅲ度子宫脱垂合并阴道膨出患者应用经阴道全子宫全阴道切除术的临床疗效。方法:随机抽取 29例我院妇产科收治的Ⅲ度子宫脱垂合并阴道膨出患者,将接受经阴道全子宫全阴道切除术的患者纳入观察组( n=16),将接受经阴道全子宫切除术联合修补治疗的患者纳入对比组( n=13)。结果: 2组患者出血量差异不存在统计学意义( t=0.7260, p=0.0524),观察组患者排气时间短于对比组,差异存在统计学意义( t=13.2502, p=0.0118),住院时间短于对比组,差异存在统计学意义( t=16.2930, P=0.0259)。观察组患者并发症总发生率为 18.75%,对比组并发症总发生率为 46.15%,观察组并发症总发生率明显较对比组患者低, 2组差异存在统计学意义( x2=17.8732, p=0.0159)。结论:Ⅲ度子宫脱垂合并阴道膨出患者应用经阴道全子宮全阴道切除术可缩短患者术后恢复时间且具有更高的应用安全性。 [关键词 ]经阴道全子宫全阴道切除术 ;Ⅲ度子宫脱垂 ;阴道膨出 [Abstract] Objective: To study the clinical effect of transvaginal hysterectomy in patients with third degree uterine prolapse and vaginal prolapse. Methods: 29 patients with third degree uterine prolapse and vaginal prolapse were randomly selected. The patients who received transvaginal hysterectomy were included in the observation group (n = 16), and the patients who received transvaginal hysterectomy and repair were included in the control group (n = 13). Results: there was no significant difference in the amount of bleeding between the two groups (t = 0.7260, P = 0.0524), the exhaust time of the observation group was shorter than that of the control group, the difference was statistically significant (t = 13.2502, P = 0.0118), the length of stay was shorter than that of the control group, and the difference was statistically significant (t = 16.2930, P = 0.0259). The total incidence of complications was 18.75% in the observation group and 46.15% in the control group. The total incidence of complications in the observation group was significantly lower than that in the control group. The difference between the two groups was statistically significant (x2 = 17.8732, P = 0.0159). Conclusion: transvaginal hysterectomy can shorten the recovery time of patients with third degree uterine prolapse and vaginal prolapse.
简介: [摘要 ]目的:研究Ⅲ度子宫脱垂合并阴道膨出患者应用经阴道全子宫全阴道切除术的临床疗效。方法:随机抽取 29例我院妇产科收治的Ⅲ度子宫脱垂合并阴道膨出患者,将接受经阴道全子宫全阴道切除术的患者纳入观察组( n=16),将接受经阴道全子宫切除术联合修补治疗的患者纳入对比组( n=13)。结果: 2组患者出血量差异不存在统计学意义( t=0.7260, p=0.0524),观察组患者排气时间短于对比组,差异存在统计学意义( t=13.2502, p=0.0118),住院时间短于对比组,差异存在统计学意义( t=16.2930, P=0.0259)。观察组患者并发症总发生率为 18.75%,对比组并发症总发生率为 46.15%,观察组并发症总发生率明显较对比组患者低, 2组差异存在统计学意义( x2=17.8732, p=0.0159)。结论:Ⅲ度子宫脱垂合并阴道膨出患者应用经阴道全子宮全阴道切除术可缩短患者术后恢复时间且具有更高的应用安全性。 [关键词 ]经阴道全子宫全阴道切除术 ;Ⅲ度子宫脱垂 ;阴道膨出 [Abstract] Objective: To study the clinical effect of transvaginal hysterectomy in patients with third degree uterine prolapse and vaginal prolapse. Methods: 29 patients with third degree uterine prolapse and vaginal prolapse were randomly selected. The patients who received transvaginal hysterectomy were included in the observation group (n = 16), and the patients who received transvaginal hysterectomy and repair were included in the control group (n = 13). Results: there was no significant difference in the amount of bleeding between the two groups (t = 0.7260, P = 0.0524), the exhaust time of the observation group was shorter than that of the control group, the difference was statistically significant (t = 13.2502, P = 0.0118), the length of stay was shorter than that of the control group, and the difference was statistically significant (t = 16.2930, P = 0.0259). The total incidence of complications was 18.75% in the observation group and 46.15% in the control group. The total incidence of complications in the observation group was significantly lower than that in the control group. The difference between the two groups was statistically significant (x2 = 17.8732, P = 0.0159). Conclusion: transvaginal hysterectomy can shorten the recovery time of patients with third degree uterine prolapse and vaginal prolapse.