中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
CHINESE JOURNAL OF MATERNAL AND CHILD HEALTH RESEARCH
2013年
6期
941-943
,共3页
腹腔镜子宫全切除术%经腹腔镜处理残端%经阴道处理残端%术后远期并发症
腹腔鏡子宮全切除術%經腹腔鏡處理殘耑%經陰道處理殘耑%術後遠期併髮癥
복강경자궁전절제술%경복강경처리잔단%경음도처리잔단%술후원기병발증
laparoscopic hysterectomy%laparoscopic treatment of stump%trans-vaginal processing stump%long-term postoperative complications
目的：比较非脱垂子宫妇科腹腔镜下子宫全切术术中经腹腔镜处理残端和经阴道处理残端两种术式的术后远期并发症和相关因素。方法回访调查2006年6月至2012年12月期间，320例非脱垂子宫妇科腹腔镜下子宫全切术患者的资料，分析术后并发症的相关情况。其中164例腹腔镜子宫全切除术术中经腹腔镜处理残端，156例经阴道处理残端。结果两种术式全子宫切除术的远期并发症主要有围绝经期综合征、生殖道感染、阴道残端息肉、阴道残端脱垂等，其发生比例分别为：60．13％、38．13％、14．38％、4．06％。两种术式在围绝经期综合征、生殖道感染这两项并发症的发生率比较无显著差别；经腹腔镜处理残端组的阴道残端息肉发生率和阴道残端脱垂症的发生率均低于经阴道处理残端组，差异有统计学意义（χ2值分别为6．07、4．30，均P＜0．05）。结论妇科腹腔镜下子宫全切术后的远期主要并发症的发生率与对阴道残端处理方式密切相关。提高手术医师的操作技能，严格选择手术适应症，规范手术操作，是降低并发症发生率的关键。
目的：比較非脫垂子宮婦科腹腔鏡下子宮全切術術中經腹腔鏡處理殘耑和經陰道處理殘耑兩種術式的術後遠期併髮癥和相關因素。方法迴訪調查2006年6月至2012年12月期間，320例非脫垂子宮婦科腹腔鏡下子宮全切術患者的資料，分析術後併髮癥的相關情況。其中164例腹腔鏡子宮全切除術術中經腹腔鏡處理殘耑，156例經陰道處理殘耑。結果兩種術式全子宮切除術的遠期併髮癥主要有圍絕經期綜閤徵、生殖道感染、陰道殘耑息肉、陰道殘耑脫垂等，其髮生比例分彆為：60．13％、38．13％、14．38％、4．06％。兩種術式在圍絕經期綜閤徵、生殖道感染這兩項併髮癥的髮生率比較無顯著差彆；經腹腔鏡處理殘耑組的陰道殘耑息肉髮生率和陰道殘耑脫垂癥的髮生率均低于經陰道處理殘耑組，差異有統計學意義（χ2值分彆為6．07、4．30，均P＜0．05）。結論婦科腹腔鏡下子宮全切術後的遠期主要併髮癥的髮生率與對陰道殘耑處理方式密切相關。提高手術醫師的操作技能，嚴格選擇手術適應癥，規範手術操作，是降低併髮癥髮生率的關鍵。
목적：비교비탈수자궁부과복강경하자궁전절술술중경복강경처리잔단화경음도처리잔단량충술식적술후원기병발증화상관인소。방법회방조사2006년6월지2012년12월기간，320례비탈수자궁부과복강경하자궁전절술환자적자료，분석술후병발증적상관정황。기중164례복강경자궁전절제술술중경복강경처리잔단，156례경음도처리잔단。결과량충술식전자궁절제술적원기병발증주요유위절경기종합정、생식도감염、음도잔단식육、음도잔단탈수등，기발생비례분별위：60．13％、38．13％、14．38％、4．06％。량충술식재위절경기종합정、생식도감염저량항병발증적발생솔비교무현저차별；경복강경처리잔단조적음도잔단식육발생솔화음도잔단탈수증적발생솔균저우경음도처리잔단조，차이유통계학의의（χ2치분별위6．07、4．30，균P＜0．05）。결론부과복강경하자궁전절술후적원기주요병발증적발생솔여대음도잔단처리방식밀절상관。제고수술의사적조작기능，엄격선택수술괄응증，규범수술조작，시강저병발증발생솔적관건。
Objective To compare the long-term postoperative complications and related factors of laparoscopic treatment of stump and trans-vaginal processing stump in laparoscopic hysterectomy of non-prolapsed uterus .Methods A return visit survey was conducted from June 2006 to December 2012 among 320 patients with gynecological laparoscopic ectomy of non-prolapsed uterus , and their postoperative complications were analyzed , including 164 cases treated by laparoscopic ectomy and 156 cases treated with vaginal hysterectomy .Results The major long-term complications of two surgical hysterectomy included peri-menopausal syndrome , reproductive tract infections , vaginal stump polyps and vaginal stump prolapse , and the incidence of them was 60.13%, 38.13%, 14.38%and 4.06%, respectively.There were no significant differences in the incidence of peri-menopausal syndrome and reproductive tract infections between two treatments .The incidence of vaginal stump polyps and vaginal stump prolapse in the group of laparoscopic surgery was lower than that of the group of trans -vaginal surgery, and the differences were significant (χ2 value was 6.07 and 4.30, respectively, both P <0.05).Conclusion The incidence of major long-term postoperative complications of gynecological laparoscopic hysterectomy is closely related to the treatment of vaginal stump .The key to reduce the incidence of complications is to improve surgeon ’ s technique , strictly select surgical indications and standardize surgical procedure .
