非脱垂大子宫阴式切除术后腹腔内大出血6例临床分析

目的:探讨非脱垂大子宫阴式切除术(TVH)术后腹腔内大出血的原因、处理及预防措施.方法:回顾性分析我院自1995年8月-2010年10月行非脱垂大子宫TVH 960例患者中6例术后早期腹腔内大出血并成功止血患者的临床资料.结果:腹腔内大出血共6例,发生率0.62%,其中子宫肌瘤4例,子宫肌腺症2例.子宫平均如孕10周大...

Analysis of 6 cases of intraabdominal bleeding after transvaginal hysterectomy for large nonprolapsed uterus

Objective： To find the cause and the prevention methods for intraabdominal bleeding after transvaginal hysterectomy （TVH） for nonprolapsed large uterus. Methods： During August 1995 to October 2010, 960 TVH cases were performed, and intraabdominal bleeding occurred in 6 patients after operation. In all of them hemosta- sis was achieved transvaginally. Results： The rate of postoperative bleeding after TVH was 0.62 %. Among these 6 patients, 4 of them were leiomyoma, 2 were adenomyoma. The uterus of these 6 patients were as large as the size of 10 gestational weeks and weighing 322 g in average. The mean blood loss during operation was 100 ml （50- 200 ml）, the mean posthysterectomy blood loss was 1 095 ml （400-1 900 ml）. Transvaginal hemostasis was suc- cessful in 5 patients, and one patient was treated conservatively with hernostatic drug and fluid infusion, with bleeding stopped spontaneously. Conclusion： Intraabdominal bleeding after TVH is one of severe postoperative complication, therefore management should be taken in time. Accurate identification of the anatomy and careful haemostasis during operation are important measures to reduce such a complication.