改良的侧对侧缝合阴道断端在腹式全子宫切除术中的临床应用

目的：为了增强全子宫切除术后盆底的支持力，减少术中出血，降低术后阴道残端出血和肉芽组织增生的发生率。方法：在Ｗａｔｓｏｎ氏侧对侧缝合阴道断端的基础上进行一些改进，使关闭阴道残端与加固主韧带的缝合一次成形。结果：与同期常规的全子宫切除术比较，改良的侧对侧缝合法减少了术中出血和降低了术后阴道残端出血与肉芽组织增生的发生率，并基本保留了阴道穹隆的解剖形态，克服了传统前后缝合法无法保留前后穹窿和Ｗａｔｓｏｎ氏侧对侧法无地保留侧穹窿的弊端。结论：改良后的侧对侧缝合阴道残端不仅继承了Ｗａｔｓｏｎ氏侧对侧缝合加固盆底支撑，减少术中失血的优点，同时简化了操作过程，使残端切口缩短，所形成术后穹窿更符合解剖。

Improved Lateral Vaginal Fragment Colporrhagia in Clinical Abdominouterectomy

Objective:This study aims at the enhancement of the pelvic floor support following the abdominouterectomy, reduction of intraoperative bleeding and the incidence of vaginal fragment bleeding and granulation after surgery.Methods:An improvement of Watson's lateral suture of vaginal fragment was made so that the suture which closes the vaginal fragment and reinforces the main ligament could be completed at only one try.Results:The introduction of this improved lateral colorrhagia led to a decrease in intraoperative bleeding, postoperative vaginal fragment bleeding and granulation, with a resultant retaining of the anatomical form of the vaginal fornix which can not be achieved by Watson's method and other traditional methods.Conclusion:The improved suture not only maintains Watson's reinforcement of the pelvic floor, which may result in a reduction of intraoperative bleeding, but also simplifies the operation and shortens the fragment incision, which results in a more anatomical agreement of the postoperative fornix.