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【摘要】目的：观察保留子宫动脉、卵巢动脉、三角形次全切除子宫治疗顽固性功血的效果分析。方法：选择符合条件的功血患者42例，随即取样，研究组21例：采取保留子宫动脉、卵巢动脉、三角形次全切除子宫术式；对照组21例，采用常规的腹式全子宫切除术式。术后2年随访，比较两组病例经予同术式治疗后动脉卵巢功能及盆底功能的差异。结果：顽固性功血均治愈。研究组21例术后出现腰腹及阴道坠胀感占9.5%，需口服激素替代治疗占4.7%.对照组分别为80%及52.3%。结论：保留子宫动脉、卵巢动脉、三角形次全切除子宫治疗顽固性功血维持了盆底结构稳定性，保留了卵巢功能达到了治疗目的。值得临床推广和应用。
【关键词】保留子宫；卵巢动脉；子宫切除术；顽固性功血
The effect of retention of uterine, ovarian artery, subtotal triangle hysterectomy for treating intractableDUB
Lin Fa Miao
(Liao Bu, Dongguan City, Guangdong Province, obstetrics and gynecology,523400)
【Abstract】 Objective: To observe the effect of retention of uterine, ovarian artery, subtotal triangle hysterectomy for treating intractableDUB.. Methods: Eligible patients with 42 cases of DUB, then were divided of 21 cases to take retained uterine artery, ovarian artery, triangular surgical subtotal hysterectomy; the control group of 21 cases were given the conventional abdominal hysterectomy type. After 2 years follow-up, two groups of patients were compared to the same artery after surgical treatment of ovarian function and pelvic floor function differences. Results: intractable uterine bleeding were cured. Study group, 21 patients had waist and heavy feeling in the vagina, 9.5% of oral hormone replacement therapy to be 4.7%. The control group were 80% and 52.3%. Conclusion: The retention of uterine artery, ovarian artery, triangular subtotal hysterectomy for intractable pelvic DUB maintain the structural stability, retention of ovarian function to achieve the treatment goal. Is worthy of promotion and application.
【Key words】Keep the uterus; ovarian artery; hysterectomy; intractable DUB
顽固性功血是指确诊为功能失调性子宫出血的患者经药物治疗及诊刮等保守治疗后症状无改善或反复发作，严重影响患者工作和生活，危害患者健康，应用保留子宫卵巢动脉三角形次全切除治疗顽固性功血取得满意的疗效，现报道如下：
1资料与方法
1.1病例选择
选择2004年1月至2007年12月确诊为顽固性功能失调性子宫出血的患者42例，年龄35-45岁，病程2-7年均无生育要求，术前均予诊刮及阴道镜下宫颈多点活检排除恶变可能的相关手术禁忌症，经腹予患者行子宫切除术。随机取样，研究组和对照组各21例。两组一般资料情况对比无显著性差异，具有可比性。
1.2治疗方法
治疗组采用保留子宫动脉、卵巢动脉、三角形次全切除子宫术式：术前准备同常规腹式全子宫切除术。硬膜外麻后患者取平卧位常规开腹、探查，上托子宫后用2把无齿卵圆钳分别钳夹子宫动静脉，在两侧宫角内侧1-1.5cm处向子宫峡部方向三角形切除子宫上段，下界在子宫膀胱腹膜返摺上方约1cm处，保留两侧壁厚约2.0cm。1号可吸收线缝合，在三角形下界开始从下到上连续“U”形对应缝合子宫侧壁，注意不能留死腔，以免坏死、感染或出血。在子宫底部打结，缝合后形成一个“小子宫”形态。对照组按照常规腹式全子宫切除术。
1.3观察指标
术后两年随访，比较两组治疗术式对术后卵巢功能及盆底功能分析、统计采用Ⅹ2检验，使用软件为SPSS18.0，P
