子宫良性病变切除子宫时预防性输卵管切除的意义探讨

发布时间：2018-03-28 08:11

本文选题：预防性输卵管切除　切入点：输卵管癌　出处：《四川大学学报(医学版)》2017年02期

【摘要】：目的通过被切除输卵管的术后病理分析探讨因子宫良性疾病行(腹腔镜)全子宫切除术或次全子宫切除术的患者同时切除双侧输卵管的临床应用价值。方法回顾性分析四川大学华西第二医院妇科2010年12月至2015年12月收治的因子宫平滑肌瘤、腺肌症等良性病变行(腹腔镜)全子宫或次全子宫切除术同时行输卵管切除术的1 272例患者临床病理资料,分析术后组织病理检查结果。结果 1 272例患者中,其中行双侧输卵管切除术1 226例,单侧输卵管切除术46例。334例患者有附件区压痛体征(26.26%),401例患者有附件区增厚体征(31.53%)。共切除输卵管2 498条,腔镜下或手术中肉眼观可见1 654条输卵管外观无明显异常(66.21%),636条输卵管管腔部分隆起(25.46%),128条输卵管红肿(5.12%),80条输卵管管腔萎缩粘连表现(3.20%);术后病理结果为2 386条(95.52%)输卵管有慢性输卵管炎症,988条(39.55%)输卵管囊肿,80条(3.20%)正常输卵管,78条(3.12%)输卵管积液,48条(1.92%)输卵管有炎性增生表现,8条(0.32%)输卵管黏膜上皮非典型增生改变、4条(0.26%)输卵管良性肿瘤及2条(0.08%)输卵管癌变。在10例输卵管癌、输卵管非典型增生患者中,发现8例患者对侧输卵管普遍存在明显慢性炎症的改变,其中输卵管非典型增生7例,输卵管癌1例。结论预防性输卵管切除可治疗输卵管炎性病变,去除癌变诱因。
[Abstract]:Objective to explore the clinical application value of laparoscopic hysterectomy or subtotal hysterectomy in patients with benign uterine diseases after resection of fallopian tubes. Methods the clinical application of bilateral fallopian tubes was reviewed. From December 2010 to December 2015, the department of gynecology of the second Huaxi Hospital, Sichuan University, was treated with uterine leiomyoma. The clinicopathological data of 1,272 patients with benign diseases such as adenomyosis underwent laparoscopic hysterectomy or subtotal hysterectomy and salpingotomy were analyzed. Bilateral salpingotomy was performed in 1 226 cases, unilateral salpingotomy in 46 cases (n = 334), tenderness signs in adnexal area (26. 26) and adnexal area thickening signs in 401 cases. A total of 2 498 oviducts were resected. There was no obvious abnormality in the appearance of 1 654 fallopian tubes under laparoscopy or operation. 66.21 / 636 tubal lumens were partially raised and 25. 4668 / 128 oviduct redness and 80 tubal lumen atrophied. The pathological results were 2 386 oviduct lumen and 95. 52) oviduct transfusion. Chronic tubal inflammation 988 (39.55) oviduct cyst 80 (3.20) normal fallopian tube 78 / 3.12) tubal effusion 48 / 1.92) oviduct inflammatory hyperplasia 8 / 0.32) fallopian tube mucosal epithelium atypical hyperplasia 4 / 0.26) fallopian tube good. Cancer of the fallopian tube. In 10 cases of cancer of the fallopian tube, Among the patients with atypical hyperplasia of fallopian tube, 8 cases were found to have obvious chronic inflammation in the contralateral fallopian tube, among which 7 cases were atypical hyperplasia of fallopian tube. Conclusion prophylaxis salpingotomy can treat fallopian tube inflammatory lesions and remove carcinomatous inducement.
【作者单位】：四川大学华西第二医院妇科出生缺陷与相关妇儿疾病教育部重点实验室;
【分类号】：R713.42

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