摘要
目的 探讨围绝经期、老年期子宫脱垂的原因及治疗的三种术式的安全性的可行性,从而寻找最合适的术式。方法 回顾分析1998～2003年我院妇科收治的102例围绝经期、老年期子宫脱垂病人,根据子宫脱垂的程度,分别给予阴式全子宫切除术┼阴道前后壁修补术、曼氏手术、阴道纵隔成形术。结果 手术时间:阴式全宫加阴道前后壁修补术最长,平均120分钟,其次为曼氏手术,平均72分钟,阴道纵隔成形术最短,平均45分钟,术中出血量依次为平均135毫升,110毫升,72毫升,各组之间差异有显著性(P<0.05)。本组90例在非产褥期发病,距末次分娩至少5年以上,全部接受相应的手术治疗。结论 阴式全宫手术术式复杂,适合较年轻、体质好的患者,曼氏手术适合脱垂较轻、宫颈长及肥大的患者,纵隔成形术安全、简单,适合年老体弱的患者。本病的发病主要原因不再是分娩损伤所致,而是与卵巢雌激素水平低落、生殖器官萎缩、子宫各韧带及盆底组织松弛无力有关,治疗措施以手术为佳。
Objective To study the causes and to explore the safety and possibilities of 3kinds of surgeries of uterine prolapse during peri-menopause and senility and then find the best one .Methods We reviewed 102 patients suffered from prolapse of uterus in peri-menopause and senility during1998~2003. Based on the degrees of uterine prolapse , the patients were treated vaginal hysterectomyuniting reconstruction of vaginal wall in both front and rear ,Manchester' operation, and partialcolpocleisis. Result The optrating time and blood loss volume of the colpohysterectomy and anteriorand posterior wall colporrhaphy , Manchester'operation and partial colpocleisis is 120min,135ml; 72min,110ml; 45min,72ml, respectively. There's significant difference among them (P<0.05). 90 cases sufferedthe disease beyond puerperium for over 5 years after their last deliverg. All cases had experiencedrelative surgery remedy. Conclusion The colpohysterectomy and anterior and posterior wall colporrha-phy is complex ,suitable to young patients ; Manchester'operation suitable to the not sever and fatcervix; Partial colpocleisis is simple and safe suitable to the senile. The disease doesn't mainly resultfrom delivery injury no longer .It does relate to lower estrogen of ovarian, withered reproductiveorgans, and slackness of uterine ligaments and pelvic floor. The best method of treating the disease isoperation.
出处
《国际医药卫生导报》
2004年第10期24-27,共4页
International Medicine and Health Guidance News
关键词
围绝经期
老年期
子宫脱垂
手术治疗
Peri-menopause Senility Prolapse of uterus Surgery remedy
