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目的 :探讨评分法在选择子宫切除途径中的可行性 ,从而保证手术安全。方法 :对 12 9例非脱垂子宫患者 ,综合阴道宽松度、子宫大小、宫颈外口距处女膜距离及子宫下移度四项评分。总分 8分 ,依分值高低分为 8分～ 6分、5分～ 3分、2分～ 1分三组并对相关因素做对比分析。结果 :评 8分～ 6分组和 5分～ 3分组 (119例 )均成功经阴道切除 ,评 2分～ 1分组 (10例 )经腹手术 ,阴式子宫切除率 92 % ;8分～ 6分组与 5分～ 3分组比较 ,年龄、手术时间差异极显著 (P<0 .0 0 1) ,出血量、子宫大小差异显著 (P<0 .0 5 ) ,平均住院日、肠功能恢复情况、附件切除率无差异 (P<0 .0 5 )。结论 :运用评分法可以估计手术难易程度 ,便于术前正确选择病例 ,从而保障手术安全。
Objective: To explore the feasibility of scoring in the choice of hysterectomy approach to ensure the safety of surgery. Methods: One hundred and ninety-nine patients with non-prolapsed uterus were enrolled in the study. Four factors including vaginal loosening degree, uterine size, distance between uterine cervix and uterus were evaluated. The total score of 8 points, according to the level of points is divided into 8 points to 6 points, 5 points to 3 points, 2 points to 1 point three groups and comparative analysis of related factors. Results: All the patients underwent 8 to 6 and 5 to 3 sub-groups (119 cases) successfully underwent vaginal resection. The patients underwent 2-to-1 subgroups (10 cases) underwent transabdominal hysterectomy. The hysterectomy rates were 92% and 8 to 6 There were significant differences in age and operation time between grouping and 5 points to 3 groups (P <0.01), bleeding volume and uterine size (P <0.05), average length of stay, recovery of intestinal function , No difference in attachment resection rate (P <0. 05). Conclusion: The grading method can be used to estimate the degree of difficulty in operation and facilitate the correct selection of cases before operation, so as to ensure the safety of operation.