论文部分内容阅读
目的探讨经阴道和经腹部全子宫切除术在临床效果、并发症和疼痛评分上的差异性。方法随机选取2010年12月-2012年11月在湖南省妇幼保健院接受全子宫切除术230例作为调查对象,分成2组,观察组予以经阴道切除子宫(TVH)治疗,对照组予以经腹部切除子宫(TAH)治疗,比较两组不同治疗后的效果。结果在术中出血量和住院费用上两组差异无统计学意义(P>0.05);从手术时间、下床时间、肛门排气时间、住院时间、输血量、Hb差值以及体温变化情况看,TVH组明显优于TAH组,差异有统计学意义(P<0.05);VAS疼痛评分结果显示随着术后恢复的时间长而疼痛的程度降低,术后当日在疼痛评分例数上差异无统计学意义(P>0.05);但术后第1 d和第3 d比较,TVH组疼痛程度明显优于TAH组,差异有统计学意义(P<0.05);在残端出血和围绝经期症状及阴道干涩上两组差异无统计学意义(P>0.05);从近期的尿路感染、阴道膀胱瘘、腹部切口愈合不良、深静脉血栓形成,远期的性功能下降、残留卵巢综合症、心血管疾患等情况看,两组比较差异有统计学意义(P<0.05)。结论经阴道全子宫切除术临床效果满意,术后疼痛恢复快,并发症低,是治疗子宫疾病的首选治疗方法。
Objective To investigate the differences of clinical effects, complications and pain scores between transvaginal and transabdominal total hysterectomy. Methods 230 cases of total hysterectomy were randomly selected from December 2010 to November 2012 in Hunan MCH. The patients were divided into two groups. The patients in the observation group were treated by transvaginal hysterectomy (TVH) Hysterectomy (TAH) treatment, the two groups after the treatment of different effects. Results There was no significant difference in blood loss and hospitalization between the two groups (P> 0.05). From the time of operation, the time of getting out of bed, the time of anus discharge, the length of hospital stay, the amount of blood transfusion, the difference of Hb and the changes of body temperature , TVH group was significantly better than the TAH group, the difference was statistically significant (P <0.05); VAS pain score results show that with the recovery time is long and the degree of pain decreased, the day after the pain score on the number of cases were no difference (P> 0.05). However, the pain in TVH group was significantly better than that in TAH group on the 1st and 3rd day after operation (P <0.05). In the stump bleed and perimenopause Symptoms and vaginal dryness had no significant difference between the two groups (P> 0.05); from the recent urinary tract infection, vaginal bladder fistula, incision poor healing, deep venous thrombosis, long-term decline in sexual function, residual ovarian syndrome , Cardiovascular disease, etc., the difference between the two groups was statistically significant (P <0.05). Conclusion Transvaginal hysterectomy with satisfactory clinical results, postoperative recovery of pain, complications and low, is the treatment of choice for the treatment of uterine disease.