改良式子宫切除临床疗效观察

目的：观察下腹小横切口行改良式全子宫切除术的效果。方法：20例采用改良术式行全子宫切除术与20例采用常规术式进行比较。改良的主要步骤有：（1）腹壁小横切口；（2）集束法处理圆韧带及附件每侧只缝扎1次；（3）不将子宫体提出切口。操作全在腹腔进行；（4）保留的大部分主韧带、骶骨韧带，筋膜内子宫切除。结果：改良后全子宫切除手术有如下优点：（1）改良组的切口长度小于常规组，差异有显著性（P〈0．01）；手术切口小，满足了患者对手术切口美观的要求；（2）改良组的手术时间、出血量、术后排气时间和住院时间均少于常规组，差异有显著性（P〈0．05）；（3）术后患者对该手术方式都非常满意。结论：改良式全子宫切除术具有创伤小、出血少、手术步骤简化、恢复快、不良反应少等优点。

Observation of the clinical effect of modified hysterectomy

Objective:To observe the clinical effect of modified panhysterectomy by small transverse incision in lower belly. Methods:20 cases of using modified panhysterectomy were compared with 20 cases of using routine operative mode.The main procedures were improved as follows:(1)The small transverse incision of lower belly was adopted;(2)Binding method was used to managed the round ligament and appendage of each side was tied for one time;(3)This operation was fully performed in abdominal cavity without pulling out womb;(4)The major main ligament and sacral ligament were retained and intra-fascia hysterectomy was performed. Results: The advantages of modified panhysterectomy were as follows:(1)The length of incision in the modified group was smaller than that in the routine group,with a significant difference(P<0.01),the perfect appearance was able to meet the demands of the patients for this operation.(2)The operative time,bleeding volume and the time of exsufflation and hospitalization after operation in modified group were less than those in routine,with significant difference(P<0.05).(3)The patients after operation were pleased with this operation. Conclusion:Modified panhysterectomy has the advantages of minor injury,less bleeding,simple operation procedure,quick recovery and less adverse reaction.