Amirikia H, Evans T N
Am J Obstet Gynecol. 1979 Jun 15;134(4):431-7. doi: 10.1016/s0002-9378(16)33085-x.
This report concerns the indications, morbidity, and death associated with 6,435 consecutive abdominal and vaginal hysterectomies at Hutzel Hospital during a 10 year period. There was an extraordinary number of high-risk patients included in this group. Morbidity and postoperative bleeding were more common following vaginal rather than abdominal hysterectomy. These complications were also more common when the operation was performed during the proliferative phase of the menstrual cycle. There were 17 deaths. Thromboembolic complications were the major cause of death. Selective use of prophylactic antibiotics and low-dose heparin and reduction in the number of blood transfusions by preoperative endocrine and hematinic therapy may reduce the postoperative morbidity and mortality rates. Probably few operations will ever contribute as much to improving the quality of life of women as do indicated hysterectomies. However, the added risk do not seem to justify utilizing this operation for the sole purpose of sterilization in preference to simpler and safer procedures.
本报告涉及胡策尔医院在10年期间连续进行的6435例腹部和阴道子宫切除术的适应症、发病率及死亡情况。该组纳入了数量异常多的高危患者。与腹部子宫切除术相比，阴道子宫切除术后发病率和术后出血更为常见。当手术在月经周期的增殖期进行时，这些并发症也更常见。有17例死亡。血栓栓塞并发症是主要死因。选择性使用预防性抗生素和低剂量肝素，并通过术前内分泌和补血治疗减少输血次数，可能会降低术后发病率和死亡率。可能很少有手术能像适当的子宫切除术那样对改善女性生活质量有如此大的贡献。然而，额外的风险似乎并不足以证明优先采用这种手术单纯用于绝育，而不选择更简单、更安全的手术方式。
