大子宫的经腹子宫切除术与经阴道子宫切除术的比较。
A comparison of abdominal and vaginal hysterectomy for the large uterus.
作者信息
Harmanli O H, Gentzler C K, Byun S, Dandolu M H V, Grody T
机构信息
Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University School of Medicine, Philadelphia, PA 19140, USA.
出版信息
Int J Gynaecol Obstet. 2004 Oct;87(1):19-23. doi: 10.1016/j.ijgo.2004.06.018.
OBJECTIVE
To compare the perioperative outcomes of women with an enlarged uterus (>or=250 g) who had abdominal and vaginal hysterectomies.
METHOD
Retrospective study of the perioperative outcomes of 288 consecutive women with an enlarged uterus, of whom 200 underwent an abdominal hysterectomy and 88 a vaginal hysterectomy, all for benign gynecological conditions.
RESULTS
Among the perioperative complications, only the risk of ileus was significantly higher in the group that underwent abdominal hysterectomy. Although the need for blood transfusions was similar between the groups, mean perioperative hemoglobin change was significantly lower for women who had the abdominal approach. Vaginal hysterectomy shortened the length of hospitalization significantly but did not affect the operative time. All of these differences remained significant after adjusting for uterine weight (P<0.05). Baseline characteristics were similar between the groups, except for uterine weight.
CONCLUSIONS
For women with a uterus weighing 250 g or more, vaginal hysterectomy shortens the hospital stay without significantly increasing perioperative morbidity when compared with the abdominal route.
目的
比较子宫增大（≥250克）的女性接受腹部子宫切除术和阴道子宫切除术的围手术期结局。
方法
对288例连续的子宫增大女性的围手术期结局进行回顾性研究，其中200例行腹部子宫切除术，88例行阴道子宫切除术，均为良性妇科疾病。
结果
在围手术期并发症中，仅腹部子宫切除组的肠梗阻风险显著更高。尽管两组间输血需求相似，但腹部手术女性围手术期血红蛋白平均变化显著更低。阴道子宫切除术显著缩短了住院时间，但不影响手术时间。在调整子宫重量后，所有这些差异仍具有显著性（P<0.05）。除子宫重量外，两组间基线特征相似。
结论
对于子宫重量≥250克的女性，与腹部手术相比，阴道子宫切除术可缩短住院时间，且不会显著增加围手术期发病率。
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