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目的 :探讨改良筋膜内子宫切除术在一些较困难的妇科腹部手术中的成功应用。方法 :对 1997年 12月～ 1999年 12月期间以此方法实施的 75例手术进行分析 ,同时与同期对照组筋膜外子宫全切术 5 6例做比较。结果 :改良筋膜内子宫切除术虽然应用在较困难的妇科手术 ,如子宫腺肌病合并盆腔子宫内膜异位症、合并盆腔慢性炎症、肥胖盆腔深者、2次及 2次以上开腹者、麻醉效果不满意盆腔不能充分暴露者及严重内科合并症需减轻对病人创伤及刺激者等 ,没有延长手术时间 ,成功地避免了周围脏器的损伤 ,减少术后并发症的发生。结论 :在一些困难、紧急的情况下 ,手术方式的选择很重要 ,既要解除疾病本身的痛苦 ,又要最大限度地减轻损伤、刺激 ,改良筋膜内子宫切除术可作为此时的选择。
Objective: To explore the successful application of modified fascia hysterectomy in some difficult gynecologic abdomen surgeries. Methods: The clinical data of 75 cases performed during this period from December 1997 to December 1999 were analyzed and compared with 56 cases of extrafascial hysterectomy in the same period. Results: Although modified fascia hysterectomy is used in more difficult gynecological surgery, such as adenomyosis combined with pelvic endometriosis, pelvic chronic inflammation, pelvic obesity deep, open more than 2 times and 2 times Those who were not satisfied with pelvic cavity insufficiency due to anesthetic effect and serious medical complications needed to reduce trauma and irritation to patients, without prolonging the operation time, successfully avoiding the damage of the surrounding organs and reducing the incidence of postoperative complications. Conclusion: In some difficult and emergency situations, the choice of surgical approach is very important. It is necessary to relieve the pain of the disease itself, minimize the damage, stimulate and improve the intrafascial hysterectomy.