摘要
目的 探讨经阴道非脱垂子宫切除合并附件手术（TVHA）的安全性和疗效.方法 选取2012年8月至2015年3月北京积水潭医院行TVHA的34例患者为观察组,同期选取行经腹部全子宫切除合并附件手术（TAHA）的35例患者为对照组.记录2组手术时间、术中出血量、肛门排气时间、术后最高体温、术后第1天血红蛋白下降水平和术后住院时间.比较2组围术期手术指标、手术指征和伴随附件手术类型.分析观察组患者临床资料和围术期手术指标之间的相关性.结果 观察组术中出血量明显多于对照组[200（100,300） ml比150（100,200） ml],术后肛门排气时间、术后住院时间明显短于对照组[1.5（1.0,2.0） min比2.0（2.0,2.0）min,4（3,5）d比5（5,6）d],差异均有统计学意义（均P＜0.05）.2组其余围术期手术指标比较,差异无统计学意义（P＞0.05）.2组手术指征和附件手术类型比较差异无统计学意义（P＞0.05）.观察组术中出血量与术后第1天血红蛋白下降水平呈高度相关（r=0.802 9,P＜0.05）,术中出血量、术后第1天血红蛋白下降水平与手术时间中度相关（r=0.674 5、0.598 6,均P＜0.05）,体重指数与手术时间、术后最高体温与术后住院时间呈低度相关（r=0.373 2,P＜0.05）,子宫腺肌症与术后肛门排气时间存在相关性（P＜0.05）.其余临床资料和围术期手术指标间无显著相关性.结论 TVHA手术具有体表无创、体内微创、肠功能恢复快和损伤小的优点,安全、有效.
Objective To determine the safety and effectiveness of simultaneous operation of total vaginal hysterectomy for non-prolapsed uteri and adnexal surgery （TVHA）.Methods Totally 34 patients underwent TVHA （observation group） and 35 patients underwent simultaneous operation of abdominal hysterectomy and adnexal surgery （TAHA） （control group） from August 2012 to March 2015 were enrolled.The operation duration,blood loss,anal exsufflation time,the highest postoperative temperature,change of hemoglobin level on the first postoperative day and postoperative hospitalization duration stay were recorded.The perioperative indicators,operation indications and adnexal operation type were compared.The correlations of clinical data and perioperative indicators were analyzed in observation group.Results The blood loss in observation group was significantly greater than that in control group[200 （100,300） ml vs 150 （100,200） ml],the anal exsufflation time and postoperative hospitalization duration in observation group were significantly shorter than those in control group [1.5 （1.0,2.0） min vs 2.0 （2.0,2.0） min,4 （3,5） d vs 5 （5,6） d] （P〈0.05）;the other perioperative indicators were not significantly different between groups （P 〉 0.05）.The operative indications and adnexal operation type were not significantly different between groups （P 〉 0.05）.The blood loss were highly correlated with the change of hemoglobin level on the first postoperative day （r =0.802 9,P 〈 0.05）;the blood loss and change of hemoglobin level on the first postoperative day were moderately corre]ated with the operative duration （r =0.674 5,0.598 6,both P 〈 0.05）;the highest postoperative temperature was lowly correlated with the postoperative hospitalization duration （r =0.373 2,P 〈 0.05）;adenomyosis was correlated with the postoperative anal exsufflation time （P 〈 0.05）.No significant correlations between the other clinical data and perioperative indicators were found.Conclusio
出处
《中国医药》
2016年第3期415-419,共5页
China Medicine
关键词
阴道子宫全切术
非脱垂子宫
附件手术
微创
Hysterectomy,vaginal
Non-prolapsed uterus
Adnexal surgery
Minimally invasive
