腹腔镜辅助阴式切除巨大子宫临床分析
腹腔镜辅助阴式,,腹腔镜辅助阴式；切除；巨大子宫,1资料与方法,2结果,3讨论,【参考文献】
【摘要】 目的 探讨腹腔镜辅助阴式切除巨大子宫的方法和效果。方法 1998年3月～2005年9月采用腹腔镜辅助阴式切除巨大子宫(孕16～22周)33例。腹腔镜下完成保留或切除附件，钛夹夹持或丝线结扎子宫血管，剪开膀胱腹膜反折并下推膀胱，切断子宫动静脉和宫旁组织，转阴式完成剩余主韧带和骶子宫韧带的断离，经阴道切碎子宫或剔除肌瘤取出。结果 33例手术均成功完成。手术时间100～250min，平均125min。估计失血量80～500ml，平均120ml。切除子宫称重450～1100g，平均620g。术后肛门排气时间17～26h，平均20h。术后下床活动时间20～32h，平均23h。术后出院时间3～5天，平均4天。结论 腹腔镜辅助阴式切除巨大子宫有效、安全、可行。【关键词】 腹腔镜辅助阴式；切除；巨大子宫
Analysis of laparoscopically assisted vaginal hysterectomy(huge uterus)
GAO Dong-xia,LI Chun-mei,LI Xia,et al.
The 520th Hospital of PLA, Mianyang 621000,China
【Abstract】 Objective To discuss the methods and effects of laparoscopically assisted vaginal hysterectomy(huge uterus).Methods From March 1998 to September.2005,laparoscopically assisted vaginal hysterectomy has been taken in 33 cases(the size is about uterus of 16～22 weeks pregnancy).Reserve or remove ovaries,titanic nips clamp or threads ligate the uterine vessels,cut the peritoneum retraced above bladder,get the bladder down,cut the uterine arteries and veins,cut cardinal ligaments and utero-sacral ligments through vagina,smash the uterus or resect the myoma and then get them out.Results 33 cases were finished successfully.Operations took 100 to 250 minutes,125 minutes averaged.Blood lost 80 to 500ml,120 averaged.The uterus weights 450 to 1100g,620g averaged.It took 17 to 26 hours from finishing the operations to breaking wind,20 hours averaged.The patients could do some exercise out of bed 20 to 32 hours after operations,23 averaged.It took 3 to 5 days from completing the operations to leave hospital,4 days averaged.Conclusion Laparoscopically assisted vaginal hysterectomy(huge uterus)is effective,safe and feasible. ......
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