經(jīng)腹改良式全子宮切除術(shù)43例臨床觀察
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[摘要] 目的 探討經(jīng)腹改良式全子宮切除術(shù)的綜合療效。方法 選取2008年1月～2010年12月于本院進(jìn)行全子宮切除術(shù)的85例患者為研究對(duì)象，將其隨機(jī)分為對(duì)照組(傳統(tǒng)全子宮切除術(shù)組)42例和觀察組(經(jīng)腹改良式全子宮切除術(shù)組)43例，后將兩組患者的手術(shù)時(shí)間、術(shù)中出血量、排氣時(shí)間、下地活動(dòng)時(shí)間、并發(fā)癥發(fā)生率、患者滿意率及手術(shù)前、手術(shù)后3、7 d的QOL評(píng)分進(jìn)行統(tǒng)計(jì)及比較。結(jié)果 觀察組的手術(shù)時(shí)間、排氣時(shí)間及下地活動(dòng)時(shí)間均短于對(duì)照組，術(shù)中出血量小于對(duì)照組，并發(fā)癥發(fā)生率低于對(duì)照組，患者滿意率高于對(duì)照組，術(shù)后3、7 d的QOL評(píng)分均高于對(duì)照組，P均<0.05，差異均有統(tǒng)計(jì)學(xué)意義。結(jié)論 經(jīng)腹改良式全子宮切除術(shù)臨床優(yōu)點(diǎn)較多，患者滿意率也較高，可在基層醫(yī)院中進(jìn)行應(yīng)用。
[關(guān)鍵詞] 經(jīng)腹改良式全子宮切除術(shù)；傳統(tǒng)全子宮切除術(shù)；綜合療效；對(duì)比
[中圖分類號(hào)] R713.4+2 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-4721(2012)02(a)-0027-02
The clinical observation of 43 cases of abdominal improved hysterectomy
TIAN Xiangling
Department of Obstetrics, The People's Hospital of Pingyu Town in Henan Province, Pingyu 463400, China
[Abstract] Objective To study the comprehensive therapeutic effect of abdominal improved hysterectomy. Methods Eighty five cases treated with hysterectomy in our hospital from January 2008 to December 2010 were selected as research object, and they were randomly divided into control group(traditional hysterectomy group)of 42 cases and observation group (abdominal improved hysterectomy group) of 43 cases, then the operation time, intraoperative blood loss, exhaust time, activity time, incidence of complications, patients′ satisfaction rate and QOL score before and after the operation at third and seventh day were analyzed and compared. Results The operation time, exhaust time and activity time of observation group were all shorter than those of control group, the intraoperative blood loss was less than that of control group, incidence of complications was lower than that of control group, patients′ satisfaction rate was higher than that of control group, QOL score after the operation at third and seventh day were higher than those of control group, all P<0.05, there were significant differences. Conclusion The clinical advantages of abdominal improved hysterectomy is more， patients′ satisfaction rate is higher，and it can be applied to primary hospital.
[Key words] Abdominal improved hysterectomy; Traditional hysterectomy; Comprehensive therapeutic effect; Comparison
子宮切除術(shù)是臨床婦科中的常見手術(shù)，其術(shù)式種類較多，效果不一[1]。本文中筆者就經(jīng)腹改良式全子宮切除術(shù)的綜合療效進(jìn)行觀察，現(xiàn)將結(jié)果總結(jié)報(bào)道如下：
1資料與方法
1.1一般資料
選取2008年1月～2010年12月于本院進(jìn)行全子宮切除術(shù)的85例患者為研究對(duì)象，將其隨機(jī)分為對(duì)照組(傳統(tǒng)全子宮切除術(shù)組)42例和觀察組(經(jīng)腹改良式全子宮切除術(shù)組)43例。對(duì)照組的42例患者中，年齡37～57歲，平均(50.2±4.5)歲，子宮大小孕正�！�15周，平均大小(10.3±1.5)周，疾病種類：子宮肌瘤25例，子宮肌腺瘤10例，卵巢惡性腫瘤4例，其他3例。觀察組的43例患者中，年齡36～57歲，平均(50.5±4.3)歲，子宮大小孕正�！�15周，平均大小(10.5±1.4)周，疾病種類：子宮肌瘤24例，子宮肌腺瘤10例，卵巢惡性腫瘤6例，其他3例。兩組患者各項(xiàng)基本資料比較，P均>0.05，兩組患者具有可比性。
1.2方法
對(duì)照組采用傳統(tǒng)的全子宮切除術(shù)進(jìn)行治療，麻醉后取腹部正中切口10 cm左右，然后逐層分離各層腹壁組織，然后進(jìn)行子宮的切除，最后縫合各層組織。觀察組采用經(jīng)腹改良式全子宮切除術(shù)進(jìn)行治療，麻醉后取恥骨聯(lián)合處大約3指處做一個(gè)橫行切口，切口大小為6~7 cm左右，然后逐層慢慢分離，分離過程中要做到細(xì)致輕柔，三指入腹腔將子宮拉至腹壁外后進(jìn)行子宮切除，然后進(jìn)行后期處理及縫合等。后將兩組患者的手術(shù)時(shí)間、術(shù)中出血量、排氣時(shí)間、下地活動(dòng)時(shí)間、并發(fā)癥發(fā)生率、患者滿意率及手術(shù)前、手術(shù)后3、7 d的QOL評(píng)分進(jìn)行統(tǒng)計(jì)及比較。
1.3評(píng)價(jià)標(biāo)準(zhǔn)
QOL評(píng)分以滿分百分為生存質(zhì)量最佳，其涉及患者生存質(zhì)量中的生理和心理兩方面的評(píng)分，每個(gè)項(xiàng)目又分為4個(gè)小的評(píng)估項(xiàng)目，總分值范圍為0~100分，分值越低表明生存質(zhì)量越差，本量表涉及影響患者生存質(zhì)量的各個(gè)細(xì)節(jié)方面[2]。
1.4統(tǒng)計(jì)學(xué)處理
將本文中所得數(shù)據(jù)采用統(tǒng)計(jì)學(xué)軟件包SPSS 14 ......
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