全子宫切除术后输卵管脱垂的诊治及高危因素分析

Fallopian tube prolapse after hysterectomy: Diagnosis,treatment,high risk factors

关键词:  全子宫切除术  输卵管脱垂  高危因素

Key words:  [Key words] hysterectomy  fallopian tube prolapse  risk factors

摘要:

[摘要] 目的探讨全子宫切除术后输卵管脱垂(fallopian tube prolapse，FTP)的诊治及影响其发生的高危因素。方法　2007年12月—2012年9月大连市妇产医院行各类全子宫切除术共4242例,6例患者术后发生输卵管脱垂，于门诊行阴式高位结扎、患侧部分输卵管切除及阴道残端修补术；另有1例患者为外院行经腹全子宫切除术后发生FTP转入，住院行腹腔镜下双侧输卵管切除术。结果　6例于门诊治疗的输卵管脱垂患者，5例痊愈，1例阴道流血治愈、下腹痛好转；1例住院手术治疗的患者痊愈。结论　全子宫切除术后输卵管脱垂依靠病理诊断明确，治疗后预后良好；术前贫血、阴道炎症、盆腔粘连、未行阴道残端腹膜化、不固定附件、留置阴道T型引流管、术后发热以及术后阴道流血是影响FTP发生的高危因素。

Abstract:

[Abstract] Objective To investigate the clinical diagnosis, treatment and risk factors of fallopian tube prolapse (FTP) after hysterectomy. Methods Among 4242 patients, who received hysterectomy from 2007 December to 2012 September in Dalian Maternal and Child Health Hospital, 6 patients had postoperative fallopian tube prolapse and received transvaginal high ligation, partial salpingectomy and vaginal stump prosthesis in the clinic. One FTP patient was transferred from an outside hospital after hysterectomy and received laparoscopic bilateral salpingectomy. Results Among the 6 FTP patients who received operation in the clinic, 5 achieved full recovery and 1 patient had vaginal bleeding controlled and improved lower abdominal pain. The patient transferred from an outside hospital was also cured. Conclusion The prognosis of FTP is well after definite clinicopathological diagnosis and correct treatment. Preoperative anemia, vaginitis, pelvic adhesion, no vaginal stump peritoneum, no fixed accessories, indwelling vaginal T tube drainage, postoperative fever and vaginal bleeding are high risk factors for FTP.