广泛性全子宫切除术加全阴道切除术

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1、广泛全宫加全阴道切除术(关键词：阴道癌)广泛全宫加全阴道切除术广泛全宫加全阴道切除术（radicalhysterectomyandtotalvaginectomy）1-1 切口1-2 显露棘上棘带1-3 剥离骶棘肌locatedintheTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotA

2、fewbayonets,duetomissedfatal,whennightcame1-4 干纱布填塞止血1-5 切除棘间韧带1-6 剪除棘突locatedintheTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennig

3、htcame1-7 切除椎板1-8 全椎板切除1-9 单侧椎板切除1-10 切开硬脊膜locatedintheTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennightcame1-11 找出齿状韧带1-12 切断齿状韧带

4、1-13 缝合硬脊膜1-14 逐层紧密缝合切口locatedintheTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennightcame1-5 切除棘间韧带1-6 剪除棘突1-7 切除椎板1-8 全椎板切除located

5、intheTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennightcame1-9 单侧椎板切除1-10 切开硬脊膜1-11 找出齿状韧带1-12 切断齿状韧带locatedintheTomb,DongShenJiaba

6、ng,deferthenextdayfocusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennightcame1-13 缝合硬脊膜图1　椎管-脊髓探查术[适应证]原发性阴道癌或其他妇科肿瘤侵犯阴道大部分，但未波及直肠、尿道、膀胱及盆侧壁。[手术时机]1.手术应在月经期后3～5天进行。2.阴道感染者，

7、应先控制感染。[术前准备]1.阴道冲洗3～5天，每天一次。locatedintheTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennightcame2.口服肠道抗生素3～5天。[麻醉方法]1.持续硬脊膜外腔阻滞麻醉。2.

8、气管内插管全身麻醉。[手术范围]广泛子宫、全阴道切除（图1）。[体位]本术式先采用仰卧位，后采用截石位。或采用人字体位。[手术步骤与操作技术要点]手术顺序　广泛全宫→全阴道切除。腹部手术步骤：1.切口　中、下腹正中切口。2.探查　了解肿瘤与盆腔器官及阴道前后壁的关系，进一步确定手术范围。l