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目的探讨各类子宫疾病经阴道切除术的手术方法、优点、适应证及其临床应用价值。方法回顾分析中铁一局五公司医院2007年1月至2011年3月收治的66例各类子宫疾病患者的临床资料。年龄36～68岁,平均48岁。多发性子宫肌瘤32例,子宫肌瘤合并腺肌瘤16例,子宫脱垂合并阴道前后壁膨出10例,功能性子宫出血合并重度贫血8例。5例合并卵巢囊肿,20例有双侧输卵管结扎史,2例有剖宫产史。结果 66例均顺利经阴道完成全子宫切除术,无术中、术后并发症,手术时间(65±10)min,出血量(150±60)ml,术后排气时间(24±7)h,术后下床活动时间早,伤口疼痛程度轻,住院时间(7±2)d。术后2个月复诊:阴道切口愈合良好,B超检查盆腔无明显异常。结论各类子宫疾病经阴道行全子宫切除术创伤小、恢复快、费用低廉,是一种较好的手术方法。
Objective To investigate the surgical methods, advantages, indications and clinical value of transvaginal resection of various uterine diseases. Methods The clinical data of 66 patients with various types of uterine diseases admitted to the First Affiliated Hospital of China Railway from January 2007 to March 2011 were retrospectively analyzed. Age 36 ~ 68 years old, average 48 years old. 32 cases of multiple uterine fibroids, uterine fibroids with adenomyosis in 16 cases, uterine prolapse with vaginal anterior and posterior wall bulging in 10 cases, functional uterine bleeding with severe anemia in 8 cases. 5 cases with ovarian cysts, 20 cases of bilateral tubal ligation history, 2 cases of cesarean section history. Results All 66 cases underwent hysterectomy successfully without vaginitis. There were no intraoperative and postoperative complications (65 ± 10) min, blood loss (150 ± 60) ml and postoperative exhaust time (24 ± 7) h, bed activity early after surgery, the degree of pain in the wound, hospital stay (7 ± 2) d. 2 months after the referral: vaginal incision healed well, B-ultrasound pelvic examination no significant abnormalities. Conclusion All kinds of uterine diseases by vaginal hysterectomy trauma, fast recovery, low cost, is a better surgical method.