摘要
目的:探讨既往有盆腹腔手术史、要求保留生育功能的子宫肌瘤患者经阴道子宫肌瘤剔除术(transvaginal myomectom,TVM)的可行性。方法:对既往有盆腹腔手术史、要求保留生育功能的子宫肌瘤患者84例行TVM。随机抽取同期子宫大小、分娩史等相似的无盆腹腔手术史168例为对照组。结果:研究组中除1例因子宫腺肌病中转行阴式子宫全切术外,其余83例均手术成功。两组手术时间(研究组58分钟,对照组61分钟)比较,差异无统计学意义(P>0.05);术中出血量(研究组239ml,对照组274ml)比较,差异有统计学意义(P<0.05)。术后住院天数(研究组4.8天,对照组6.2天)比较,差异有统计学意义(P<0.05)。结论:有盆腹腔手术史不是TVM的绝对禁忌证。通过仔细术前检查,分析前次手术部位、手术类型和途径,同时具有熟练的阴道手术技巧,大部分有盆腹腔手术史者行TVM是可行的。
Objective： Discuss the feasibility of transvaginal myomectomy （TVM） used on the patients with previous pelvic surgery desire to reserve their breeding. Methods： From 2003 Jan. to 2006 Jan.We selected 84 patients with previous pelvic surgery but want to reserve reproductive capacity as study group, performed TVM among them. As the same time 168 cases TVM without pelvic surgery were chosen as control group. The birth history and the size of uterus were no difference between two groups. Results： 83 cases of study group successfully completed operations except 1 case of adenomyosis turned into transvaginal hysterectomy. The mean operative time was 68 min and 61 rain of study group and control group, respectively （P〉0.05）. The mean hemorrhage was 239 ml in study group and 274 ml of control group （ P 〈 0. 05）. The hospitalization time was 4.8 d in study group that higher than the control group （6.2 d） （ P 〈 0.05）. Conclusions： Previous pelvic surgery is net the absolute contraindication of TVM. But TVM assisted by laparoscopy or laparotomy myomectomy is the better way if found uterine fixation before operation. The special deal of the key place could decrease pelvic infection and postoperative morbidity.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2008年第8期490-492,共3页
Journal of Practical Obstetrics and Gynecology
