改良阴式子宫次全切除术治疗良性子宫病变的临床评价

目的比较改良阴式子宫次全切除术与开腹子宫次全切除术治疗良性子宫病变的临床效果。方法176例良性子宫病变患者随机分为2组，其中改良阴式次全子宫切除术组（A组）S9例，开腹子宫次全切除术组（B组）87例，比较2组患者手术及术后相关情况，并在随访期间对心理和性生活情况进行调查比较。结果阴式手术组在平均手术时间、术中出血量、手术并发症发生率、术后镇痛泵使用率、术后疼痛指数、最早下床活动时间、术后3d平均最高体温、术后胃肠恢复时间、平均住院日及住院费用等方面均较开腹手术组为佳，具有显著性差异（P〈0．05）；在随访期间进行心理和性生活调查，结果显示阴式手术组较开腹手术组较好，比较有显著性差异（P〈0．05）。结论阴式手术组较开腹手术组术后病情恢复较快，心理及性生活质量较好，可作为子宫次全切除术治疗良性子宫病变的常规进路，应当推广应用。

Clinical evaluation on the effect of modified subtotal vaginal hysterectomy to treat the patients with benign metropathia

Objective To compare the effect of modified subtotal vaginal hysterectomy and subtotal abdominal hysterectomy. Methods 176 cases of benign metropathia were divided into two groups, group A：snbtotal vaginal hysterectomy （89 cases）,group B：subtotal abdominal hysterectomy （87 cases）. Then compared the correlation of operation and postoperative between two groups. We compared psychology and sexual life survey between two groups during the follow up period.Results Subtotal abdominal hysterectomy had longer operation time, larger blood loss during operation,higher analgesia pump use rate postoperative,higher pain index postoperative,longer earlier time of activities, higher average highest temperature of 3 d postoperative, longer gastrointestinal function recovery time after operation postoperative recovery,longer average hospitalization days after the operations and higher hospitalization expenses than those in subtotal vaginal hysterectomy group. There was high significant difference between them （P〈0.05）. There was significant difference in the psychology and sexual life between two groups（P〈0.05 ）.Conclusion Subtotal vaginal hysterectomy is more preferable recovery than subtotal abdominal hysterectomy and had better psychology and sexual life. It may be a conventional approach to treat benign metropathia, and it＇ s worth to extend the application of it.