生殖器结核患者行阴式子宫切除术时并发症发生率增加。

Increased complication rates in vaginal hysterectomy in genital tuberculosis.

机构信息

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi 110029, India.

出版信息

Arch Gynecol Obstet. 2011 Apr;283(4):831-5. doi: 10.1007/s00404-010-1463-8. Epub 2010 Apr 21.

DOI:10.1007/s00404-010-1463-8

PMID:20407908

Abstract

PURPOSE

To evaluate the complication rate in women with genital tuberculosis undergoing vaginal hysterectomy.

METHODS

A retrospective study of seven women who underwent vaginal hysterectomy and anterior and posterior colpoperineorraphy for uterovaginal prolapse and found to have genital tuberculosis and 63 women who underwent vaginal hysterectomy during the same period without genital TB.

RESULTS

The mean age was 52.7 in the study group as compared to 47.4 years in the control group. Indications for surgery were genital prolapse in 7 (100%) women in group I, 43 (68.25%) in group II, AUB in 0 and 6 (9.5%), CIN III in 0 and 5 (7.9%), fibroid up to 10 weeks in 0 and 9 (14.31%) in group I and II, respectively. Surgery performed in group I was vaginal hysterectomy and pelvic floor repair in 7 (100%) and 43 (68.25%) in group II, while it was nondescent vaginal hysterectomy in 0 and 20 (31.7%) cases respectively. There was very high rate of complications in vaginal hysterectomy done in genital tuberculosis as compared to controls like excessive bleeding in 2 (28.56%) versus 3 (4.76%); need for relaparotomy in 1 (14.28%) case versus 0 in control; postoperative peritonitis and flare-up in 4 (57.14%) cases versus 0 in groups I and II respectively.

CONCLUSION

Vaginal hysterectomy is associated with higher complication rate in women with genital tuberculosis.

摘要

目的

评估女性生殖器结核行阴道子宫切除术的并发症发生率。

方法

回顾性分析 7 例因阴道前壁和后壁脱垂行阴道子宫切除术和前后会阴修补术且确诊为生殖器结核的患者（研究组），并与同期 63 例无生殖器结核行阴道子宫切除术的患者（对照组）进行比较。

结果

研究组平均年龄为 52.7 岁，对照组为 47.4 岁。手术指征为生殖器脱垂 7 例（100%），对照组 43 例（68.25%）；AUB 0 例，对照组 6 例（9.5%）；CIN III 0 例，对照组 5 例（7.9%）；子宫肌瘤最大 10 周，0 例，对照组 9 例（14.31%）。研究组手术方式为阴道子宫切除术和盆底修复术 7 例（100%），对照组 43 例（68.25%）；对照组行非脱垂阴道子宫切除术 0 例，20 例（31.7%）。与对照组相比，生殖器结核患者阴道子宫切除术的并发症发生率非常高，如术中出血过多 2 例（28.56%），对照组 3 例（4.76%）；需要再次剖腹探查 1 例（14.28%），对照组 0 例；术后腹膜炎和复发 4 例（57.14%），对照组均无。