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目的：探讨中等大、良性病变的非脱垂子宫经阴道行全子宫切除术的可行性。方法：87例施行此术式，其中子宫中等大（重200～750g）60例作为研究组，小子宫（＜200g）27例作为对照组，部分病例采用子宫分碎术。对两组因手术期情况进行分析。结果：研究组59倒成功地经阴道切除子宫，其中21例（35％）采用子宫分碎术，1例转经腹手术，转经腹手术率为1．7％，对照组则全部经阴道完整切除。研究组和对照组的子宫重量分别为280．18±100．40g、146．48±35．19g，差异有高度显著性（P＜0．001）；研究组的平均手术时间为83．93±26．26min,长于对照组的55．22±20．55min，差异有高度显著性（P＜0．001）；术中平均出血量为164．92±89．83ml，多于对照组的135．56±111．57ml，但差异无显著性（P＞0．05）；术后病率分别为3．33％与3．70％，差异无显著性（P＞0．05）；两组患者均无膀胱、直肠损伤，无阴道残端炎症。结论：对具备经阴道手术经验的术者，中等大、良性病变的子宫经阴道切除是安全可行的。部分病例需施行子宫分碎术，减小子宫体积，缩短手术时间，减少术中出血量和降低术后并发症。
Objective: To investigate the feasibility of transvaginal hysterectomy in non-prolapsed uterus of medium and benign lesions. Methods: Totally 87 cases were treated with this method. Among them, 60 cases were medium (weighing 200-750g) in the study group and 27 cases in the small uterus (<200g) as the control group. Some cases were treated by uterine shunting. The two groups were analyzed during the operation. Results: The study group 59 successfully transvaginal uterine vaginal removal, of which 21 cases (35%) using uterine fragmentation, 1 case of transabdominal abdominal surgery, transabdominal surgery was 1.7%, while the control group were all transvaginal Complete removal. The uterus weight of study group and control group were 280.18 ± 100.40g and 146.48 ± 35.19g respectively, the difference was highly significant (P <0.001). The average operation time of the study group was 83.93 ± 26.26min, longer than the control group 55.22 ± 20.55min, the difference was highly significant (P <0.001); intraoperative blood loss was 164.92 ± 89.83ml, more than the control group of 135. 56 ± 111.57ml, but the difference was not significant (P> 0.05). The postoperative morbidity was 3.33% and 3.70% respectively, with no significant difference (P> 0.05) No bladder, rectal injury, no vaginal stump inflammation. Conclusion: Transvaginal resection of the uterus with medium and benign lesions is safe and feasible for those who have the experience of transvaginal surgery. In some cases, hysterectomy is required to reduce the volume of the uterus, shorten the operation time, reduce the amount of intraoperative bleeding and reduce postoperative complications.