非脱垂子宫行阴式或腹式子宫切除术的疗效比较

目的探讨非脱垂子宫行阴式或腹式子宫切除术的疗效比较。方法对66例非脱垂病变子宫患者分别采用阴式子宫切除术（阴式组，32例）或腹式子宫切除术（腹式组，34例）治疗。结果两组患者手术均成功，阴式组的手术时间、术中出血量、术后镇痛率、术后肛门排气时间、术后住院时间均明显少于腹式组（P〈0．05或P〈0．01）。阴式组术后出现盆腔血肿1例．腹式组术中损伤输尿管1例，术后切15脂肪液化感染2例，两组术中术后并发症的比较无明显统计学差异（P〉0．05）。随访3～22个月，平均（13．1±2．7）个月，阴道残端愈合良好，未发现残端肉芽组织增生和阴道脱垂。结论阴式子宫切除术具有手术时间短、术中出血少、术后镇痛率低、术后肛门排气早、住院时间短、术后腹部无疤痕和术后并发症少等优点，是治疗非脱垂子宫病变的首选术式。

Comparison of the efficacy of vaginal or abdominal hysterectomy in the treatment of non-prolapsed uterus

Objective To compare the efficacy of vaginal or abdominal hysterectomy in the treatment of non-prolapsed uterus.Methods 66 cases of patients with non-prolapsed uterus lesions were used vaginal hysterectomy(vaginal group,32 patients) or abdominal hysterectomy(abdominal group,34 patients) treatment.Results Both groups of patients were operated successfully,The time,blood loss,postoperative analgesic rate,postoperative anal exhaust time,postoperative hospital stay of vaginal surgery group were significantly less than those of the abdominal group(P < 0.05 or P < 0.01).Postoperative vaginal pelvic hematoma occurred in 1 case in vaginal group,and there was 1 case with intraoperative ureteral injury in abdominal group and 2 cases with postoperative wound infection and fat liquefaction.Intraoperative and postoperative complications in both groups showed no significant difference(P > 0.05).During the follow up for 3 months to 22 months with the average(13.1 ± 2.7) months,the vaginal stump healed well and found no granulation tissue and vaginal stump prolapse.Conclusion Vaginal hysterectomy has the advantages of shorter operative time,less blood loss,lower postoperative analgesic rate,earlier postoperative flatus,shorter hospital stay,without postoperative abdominal scar and fewer complications.It is the first choice for the treatment non-prolapsed uterus.