改良腹式子宫全切术

目的 总结改良腹式子宫全切术临床体会。方法 对98例子宫全切术进行改进，采用腹壁横切口钝性撕拉开腹壁，保留腹壁下浅静脉；集束法处理子宫韧带及附件；筋膜内切除子宫，不处理子宫主、骶韧带；盆腔腹膜及壁层腹膜不缝合；筋膜层连续缝合，皮肤连同皮下脂肪仅缝3针。结果明显缩短了手术时间；减少术中出血，术后恢复快；减少脏器损伤、粘连及术后疼痛；预防附件和阴道脱垂，提高术后性生活质量：腹部美观，满足病人的心理需求；缩短住院时厄，降低住院费用。结论 改良子宫全切术优于传统术式；更适合肥胖妇女、慢性炎症及子宫内膜异位症造成的盆腔粘连病人选用。

Improved laparotomy hysterectomy

Objective To summarize the clinical experience of improved laparotomy hysterectomy.Methods A total of 98 hysterectomies were improved by mean of the abdominal wall being pulled open bluntly.Shallow vein in abdominal wall was retained.The uterine ligaments were cut off in bundles.The intrafascial hysterectomy was performed by separating cervical fascias layer from the cervix.The peritoneum and purietal peritoneum did not be sutered.Fascia was continuously sutured.The skin and fat were sutered with only 3 stitches.Results Operation time was obriously shortened.Bleeding and damaging of tissues were decresed during operation.Recovery was quicker and adhesion pain was less after operation.Appendix and prolapse of vagina were prevented.Postoperation sexual intercourse was improved.Abdominal incision was artistic.These satisfy psychological need of patients and shortened time and reduse cost of being in hospital.Conclusion Improved laparotomy hysterectomy is significantly superior to the traditional hysterectomy.It is more suitable for fat women and pelvic adhesion patients caused by chronic inflammation and endometriosis.