经腹改良式全子宫切除术43例临床观察
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[摘要] 目的 探讨经腹改良式全子宫切除术的综合疗效。方法 选取2008年1月～2010年12月于本院进行全子宫切除术的85例患者为研究对象，将其随机分为对照组(传统全子宫切除术组)42例和观察组(经腹改良式全子宫切除术组)43例，后将两组患者的手术时间、术中出血量、排气时间、下地活动时间、并发症发生率、患者满意率及手术前、手术后3、7 d的QOL评分进行统计及比较。结果 观察组的手术时间、排气时间及下地活动时间均短于对照组，术中出血量小于对照组，并发症发生率低于对照组，患者满意率高于对照组，术后3、7 d的QOL评分均高于对照组，P均<0.05，差异均有统计学意义。结论 经腹改良式全子宫切除术临床优点较多，患者满意率也较高，可在基层医院中进行应用。
[关键词] 经腹改良式全子宫切除术；传统全子宫切除术；综合疗效；对比
[中图分类号] R713.4+2 [文献标识码] A [文章编号] 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
子宫切除术是临床妇科中的常见手术，其术式种类较多，效果不一[1]。本文中笔者就经腹改良式全子宫切除术的综合疗效进行观察，现将结果总结报道如下：
1资料与方法
1.1一般资料
选取2008年1月～2010年12月于本院进行全子宫切除术的85例患者为研究对象，将其随机分为对照组(传统全子宫切除术组)42例和观察组(经腹改良式全子宫切除术组)43例。对照组的42例患者中，年龄37～57岁，平均(50.2±4.5)岁，子宫大小孕正常～15周，平均大小(10.3±1.5)周，疾病种类：子宫肌瘤25例，子宫肌腺瘤10例，卵巢恶性肿瘤4例，其他3例。观察组的43例患者中，年龄36～57岁，平均(50.5±4.3)岁，子宫大小孕正常～15周，平均大小(10.5±1.4)周，疾病种类：子宫肌瘤24例，子宫肌腺瘤10例，卵巢恶性肿瘤6例，其他3例。两组患者各项基本资料比较，P均>0.05，两组患者具有可比性。
1.2方法
对照组采用传统的全子宫切除术进行治疗，麻醉后取腹部正中切口10 cm左右，然后逐层分离各层腹壁组织，然后进行子宫的切除，最后缝合各层组织。观察组采用经腹改良式全子宫切除术进行治疗，麻醉后取耻骨联合处大约3指处做一个横行切口，切口大小为6~7 cm左右，然后逐层慢慢分离，分离过程中要做到细致轻柔，三指入腹腔将子宫拉至腹壁外后进行子宫切除，然后进行后期处理及缝合等。后将两组患者的手术时间、术中出血量、排气时间、下地活动时间、并发症发生率、患者满意率及手术前、手术后3、7 d的QOL评分进行统计及比较。
1.3评价标准
QOL评分以满分百分为生存质量最佳，其涉及患者生存质量中的生理和心理两方面的评分，每个项目又分为4个小的评估项目，总分值范围为0~100分，分值越低表明生存质量越差，本量表涉及影响患者生存质量的各个细节方面[2]。
1.4统计学处理
将本文中所得数据采用统计学软件包SPSS 14 ......
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