评分法在选择子宫切除途径中的应用价值

目的 :探讨评分法在选择子宫切除途径中的可行性 ,从而保证手术安全。方法 :对 12 9例非脱垂子宫患者 ,综合阴道宽松度、子宫大小、宫颈外口距处女膜距离及子宫下移度四项评分。总分 8分 ,依分值高低分为 8分～ 6分、5分～ 3分、2分～ 1分三组并对相关因素做对比分析。结果 :评 8分～ 6分组和 5分～ 3分组 (119例 )均成功经阴道切除 ,评 2分～ 1分组 (10例 )经腹手术 ,阴式子宫切除率 92 % ;8分～ 6分组与 5分～ 3分组比较 ,年龄、手术时间差异极显著 (P<0 .0 0 1) ,出血量、子宫大小差异显著 (P<0 .0 5 ) ,平均住院日、肠功能恢复情况、附件切除率无差异 (P<0 .0 5 )。结论 :运用评分法可以估计手术难易程度 ,便于术前正确选择病例 ,从而保障手术安全。

The value of score in selecting hysterectomy way

Objective:Probe into the feasibility of score in selecting hysterectomy way so as to ensure the safety of the operation. Methods:129 cases were given the score according to the looseness of vagina.The volume of uterus.The distance from external of cervix to hymen and downward mobitity of uterine.The patients were devided into three groups.The score in each grorp was 8～6(group 1)、5～3(group 2) and 2～1(group 3) respectively.(The total score is 8).The uterine volume、operation way 、operation time、blood loss as well as patient’s age etc,were analyzed.Results:group 3 (10 cases) completed with transabdominal hysterectomics.All cases (119) of group 1 and 2 vaginal hysterectomics were successfully completed with a incision rate 92%.The patient’s age、operation time (P<0.001)、uterine volume and blood loss(p<0.05)was found to be significantly higher in group 2 when compared with group 1.Comclusion:Patients can be selected properly according to the score which can evaluate the degree of difficulty in TVH and ensure the operation.