有剖宫产术史患者阴式子宫切除术临床分析

目的探讨有剖宫产史的患者选择阴式子宫切除术的可行性及安全性。方法回顾性分析2000年1月至2005年1月行阴式子宫切除术中的196例病例,其中有剖宫产史的72例定为A组,无腹部手术史的70例为B组,除外剖宫产的腹部手术史54例为C组。分别就手术时间、术中出血量、子宫体积及住院日进行比较。结果A组手术时间(80±26)m in,B组(68±22)m in,C组(70±16)m in,A组明显长于B组或C组(P<0.05),B组与C组手术时间相似(P>0.05)。A组子宫体积(354.2±203.6)cm3,B组(469.2±269.3)cm3,C组(425.6±196.3)cm3,A组较B、C两组均小(P<0.05),B组与C组子宫体积相似。术中出血量及住院日3组间差异无统计学意义。A组2例膀胱损伤。结论有剖宫产史者的患者选择阴式子宫切除术是可行的。

Clinical study of transvaginal hysterectomy in patients with previous history of cesarean section

Objective To assess the feasibility and safety of transvaginal hysterectomy(TVH) in patients with a previous history of cesarean section.Methods 196 women undergoing TVH were included in a retrospective study from January 2000 to January 2005.They were assigned to three groups,group A(72 cases,with a previous history of cesarean section),group B(70 cases,without a history of abdominal operation) and group C(54 cases,with a history of abdominal operation except cesarean section).The operation time,uterine size,bleeding during operation and hospitalization duration were compared among the groups.Results The operation time of group A was(80±26) minutes,group B(68±22) minutes,group C(70±16) minutes.The operation time of group A was significantly longer than that of group B or group C(P<0.05),without a significant difference between group B and group C(P>(0.05)).The uterine size was(354.2±203.6) cm~3 in group A,(469.2±269.3) cm~3 in group B,(425.6±196.3) cm~3 in group C.The uterine size of group A was significantly smaller than that of group B and group C(P<0.05),without a significant difference between the two groups.There were no difference of the bleeding volum during operation and hospitalization duration among the groups.There were 2 cases of incidental in group A.Conclusion The patients who have a previous history of cesarean section can undergo transvaginal hysterectomy.