阴式非脱垂子宫切除术并发症的发生原因及处理

目的 分析经阴道非脱垂子宫切除术并发症的发生原因,总结经验教训和防治对策.方法 回顾性对比分析2006年6月至2010年4月非脱垂子宫经阴道切除110例患者(TVH组),与同期开展的经腹子宫切除术120例患者(TAH组)的并发症.结果 TVH组发生1例直肠损伤,1例输卵管脱垂,1例腹腔内出血,4例术前与术后诊断不符合,2例术后残端出血,4例阴道残端息肉；TAH组3例术前与术后诊断不符合,4例腹壁切口液化,其中2例二期缝合,3例术后支气管肺部感染,2例阴道残端息肉；未发生腹腔内出血及脏器损伤.结论 TVH发生临近脏器损伤及术后出血的概率较TAH高,应高度重视,认真防范.

Analysis of the complication of transvaginal hysterectomy of patients with non-prolapsed uterus

Objective To explore the advantages and disadvantages of transvaginal hysterectomy for patients with non-prolapsed uterus,and explore the cause and preventive measurements of the complications of transvaginal hysterectomy.Methods The complications of transvaginal hysterectomy ( group TVH ) in 110 patients with non-prolapsed uterus and of transabdominal hysterectomy ( group TAH ) in 120 patients were compared with each other.These patients were chosen randomly from June 2006 to April 2010.Results In the TVH group,rectum hurt occurred in one patient,prolapse of fallopian tube in one patient and celiac internal bleeding in one patient.The preoperative diagnosis were not consistent with the postoperative diagnosis in four patients.Two patients encountered with postoperative residual end bleeding and four patients with vaginal residual end polyps.In the TAH group,three patients had postoperative diagnosis inconsistent with their preoperative diagnosis.In addition,there were four abdominal wall incision liquefaction ( including two phase suture in two patients),three postoperative bronchial lung infection and two residual end polyps.No celiac internal bleeding and visceral injury occurred in this group.Conclusion TVH has a higher risk of visceral injury and postoperative bleeding than TAH.These complications should be avoided when treating the patients with TVH technique.