![新编妇科手术图谱](https://wfqqreader-1252317822.image.myqcloud.com/cover/534/23313534/b_23313534.jpg)
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0003_0001.jpg?sign=1739290479-grbqNiF2leYWYwFbJMAbHGGjTdyXF59B-0-1fb604ac011893f50e5245afce0f6753)
版图4-1 输尿管逆行造影显示狭窄部位
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0003_0002.jpg?sign=1739290479-32JTqLZsGxIjhKCeHqN9nmZn1gO9A7j0-0-0f2fdb8fd2f9a6aa1c87a840da8bfff0)
版图4-3 充气后见蜂腰征
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0003_0003.jpg?sign=1739290479-dlgKRIiWwYBYxwS6D0WC6ACUbbc5nSyf-0-b87fdbbdbddfac51560b0109b73fcce2)
版图4-2 插入气囊导管
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0003_0004.jpg?sign=1739290479-R8GvffCTuP1gOBdXx9q5924S90jxESkK-0-9356340bb268aa555c23e3f1f09996af)
版图4-4 充气至蜂腰征消失
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0003_0005.jpg?sign=1739290479-rNh3DtBJTaR6y6hACCSOwU9yebMActeC-0-8900cc6a589062937704d8ec7358e0e9)
版图5-1
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0004_0001.jpg?sign=1739290479-WQlWOePlNeDhPAg8ilBYCyaRttBs4M3P-0-cec39c2aa4f3369a3a1f39cfa0a4685d)
版图5-2 A在宫旁组织中游离子宫深静脉,B示宫旁组织中的子宫深静脉
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0004_0002.jpg?sign=1739290479-HbuOsxF9YoHhxDplnT31cDlqWlfPvzp9-0-cb4cf1b22b0762ce30978d26624a0913)
版图5-3 A分离盆腔内脏神经上方的子宫深静脉,B示子宫深静脉下方的盆腔内脏神经
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0004_0003.jpg?sign=1739290479-VRUH9ta3Cq05eFGLXU1vXc7CsGPDeevZ-0-3fecdbe9bd5ef61aac74d635c476576b)
版图5-4 A在直肠旁间隙直肠侧分离腹下神经,B示腹下神经
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0004_0004.jpg?sign=1739290479-pgqALJn7BAEcDCOXeAHwwbFucqsfLyet-0-4a30cff8b066c45767d22dfc3fad6e8d)
版图5-5 A分离膀胱宫颈韧带后叶中的膀胱中静脉,B示膀胱中静脉
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0005_0001.jpg?sign=1739290479-JgTgg5JqJd9MD17J1FcglkQ1muSakMqy-0-3011d21ce20601daaebca92752ba42aa)
版图5-6 A游离膀胱下静脉,显示其下方的下腹下神经丛膀胱支,B示膀胱下静脉与下腹下神经丛膀胱支的关系
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0005_0002.jpg?sign=1739290479-2j8jhZ6OAiUn7lHXY0a7jy6Tufjzw2XA-0-6416bf33f50abf1d8d6c2531bfa3822b)
版图5-7 A从下腹下神经丛中分离出腹下神经、盆腔内脏神经、膀胱支及子宫支,B示下腹下神经丛
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0005_0003.jpg?sign=1739290479-E8OfAlejWtSt3ZMceNcP0sNTR49vAdX5-0-b053bbeefbd843f4735cc48f65d66836)
版图5-8 A分离出下腹下神经丛的子宫支,B示从下腹下神经丛中分离子宫支
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0005_0004.jpg?sign=1739290479-7WOUskGpT3l5QLwFQAIUQHWC2RUm04ZH-0-2dbade6e7b8a85140823927f04128738)
版图5-9 A分离下腹下神经丛的子宫支,显示出T形平面,B示下腹下神经丛的子宫支断端
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0006_0001.jpg?sign=1739290479-risxOoOrMsFWihvtBJyA4uRrTYW7Ue2z-0-eb66faa06cfc811f9b3e6e6015bcc38a)
版图5-10 A钳夹阴道旁组织,显示出下腹下神经丛的膀胱支,B示阴道旁组织与膀胱支的关系
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0006_0002.jpg?sign=1739290479-1wUA8VlgQI96XqjPeLHxlrv3VGix10Hq-0-b4625f9339380d3add20f5d58ef07ca5)
版图5-11 A分离阴道旁组织,保留下腹下神经丛的膀胱支,B示阴道旁组织断端及保留的膀胱支
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0006_0003.jpg?sign=1739290479-qC84OO9ybBVclodc8qqFH3AwMUnhuII1-0-f78235a88f0e9f0bb9a25a193a8c551a)
版图5-12 切除子宫后的T形神经平面示意图
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0001.jpg?sign=1739290479-dpYiLKkf8XCTMYGCnLaYHPQBGsTs7fsa-0-b96f80a6fd4b91622890dc13241e133f)
版图5-13 病灶直径小于2cm的根治性子宫颈切除术范围
1.根治性子宫切除术范围 2.根治性子宫颈切除术范围
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0002.jpg?sign=1739290479-kTlC2KdH7cmEk4wtyM7nvCaoUNLRUyFT-0-a970ac4d6ee735a2d0520b506864c04d)
版图5-14 病灶直径2~4cm的根治性子宫颈切除术范围
1.根治性子宫切除术范围 2.根治性子宫颈切除术范围
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0003.jpg?sign=1739290479-9ENIyOAwPJptXKPYhtXG24S4IQpDUDsU-0-6de62b614e8881bd5a8d0fe589b522ba)
版图5-15 分离直肠侧间隙
1.输尿管 2.直肠侧间隙
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0004.jpg?sign=1739290479-Z4ZNx2VejzKxUd3pe2MjCf1tXuThmT2d-0-d35584b6dae9940fcdee0e8304d395a5)
版图5-16 分离直肠阴道间隙
1.右骨盆漏斗韧带 2.子宫直肠间隙腹膜 3.左骨盆漏斗韧带
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0005.jpg?sign=1739290479-THqH9rrWjRHpmUhlRx5wrmtmGyrnvA2d-0-cfcc62719541e331d5514c0ccfde11f5)
版图5-17 切除1/2的骶骨韧带
1.骶骨韧带深层 2.直肠
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0006.jpg?sign=1739290479-6LkoPs7HGioQv7vtz5Jx6AMhSNjc2pmd-0-2e828b4d278a014d5039bc83360dffb8)
版图5-18 分离膀胱宫颈间隙
1.疏松组织间隙 2.膀胱宫颈间隙
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0007.jpg?sign=1739290479-VvZPLkys4QpwTpE6VSOeLeHp1qaXPaMi-0-81037fc19a141ded6aa605c81f77d0b4)
版图5-19 在输尿管下方打开输尿管隧道
1.输尿管 2.子宫动脉 3.输卵管系膜
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0008.jpg?sign=1739290479-3ruErYkfCvQhir4KX7gxD8BjwipHeTDA-0-e203d7bcdea42c9519319616c59604a5)
版图5-20 钝锐结合分离子宫动静脉暴露主韧带
1.子宫动静脉周围的疏松结缔组织 2.子宫动脉 3.输尿管 4.髂外静脉
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0001.jpg?sign=1739290479-1HdchPrbktBhXs9RzH5fU9ROkt69tmol-0-ad51b4a2d8faccec14c4eb1a965f94f8)
版图5-21 切断右侧主韧带观察主韧带周围的解剖
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0002.jpg?sign=1739290479-WMn2jHHlnBaeAD4VVC9OTQG9mmJAKSt2-0-6843f84462a6ae33be354cb8bc1fe442)
版图5-22 观察各组织器官解剖位置保留子宫动静脉
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0003.jpg?sign=1739290479-fEg60c4u5c6QcVWD7Rpqqy5WXymFShkJ-0-aeb95467818d8af312ccca936bae01ec)
版图5-23 切除3cm的阴道
1.阴道前壁 2.阴道后壁 3.阴道断端
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0004.jpg?sign=1739290479-8HWPg0RSNMnQzOkYI0DPElTolEMlVWWE-0-1415ec6e6c1692422c855559ced2150d)
版图5-24 保留子宫动脉上行支
1.子宫动脉 2.输尿管 3.膀胱 4.宫颈部 5.髂外静脉
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0005.jpg?sign=1739290479-55ArKJMY8gjZrnasMhIDyZwlJux3JbMp-0-a0e440a65425e632b0b83b3632d6c674)
版图5-25 横断宫颈
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0006.jpg?sign=1739290479-EVkCVHKamiS80PUrDv030IbrZz54S3qP-0-b71b95694bd3004b4fc0beda282bcd7c)
版图5-26 固定在节育环的橡胶管预防宫颈口粘连
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0007.jpg?sign=1739290479-jKZvwvXv4f2aSP6ApHG7HCo7M6HIsOEC-0-841f47fdd4e0f02ac9de8f8d52d53c94)
版图5-27 用补片环绕宫颈外口预防宫颈外口松弛
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0008.jpg?sign=1739290479-xxBtC6w7XdI7oEBfWYfwlPVDCiXlydYU-0-fc1f581801c126bc7c086a75976ab2c1)
版图5-28 将阴道壁缝合在宫颈外侧术后4周的宫颈外观
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0009_0001.jpg?sign=1739290479-n6K9bl0rHC4ZwugcCBY3xNqrc8GpOPxi-0-966b2bd927d23d3ada2a8ed68e847590)
版图5-29 缝合阴道时阴道壁要盖住宫颈的环形补片
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0009_0002.jpg?sign=1739290479-Wl6LrDNXKGi05yeNVqdLyNTCSNQhYrNE-0-928abf081debcdc92284884a31b7b3bb)
版图5-30 将两片聚丙烯网片形成人工主韧带和骶韧带
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0009_0003.jpg?sign=1739290479-d2dR8aC6ptFbZqQAFFDXRAX9qHg0nl0h-0-a4bcdf7d6ed664e6e34fd52425f3bfaf)
版图5-31 将聚丙烯网片缝合固定在子宫下段后壁
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0009_0004.jpg?sign=1739290479-S6snGLY83uJFObQWCmJsaEAG821jBNNf-0-54adf48a06e70eaaaebfcadd9952bd5d)
版图5-32 聚丙烯网片与骶韧带和主韧带的断端相接
1.人工骶韧带 2.子宫 3.人工主韧带
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0009_0005.jpg?sign=1739290479-tjdJ5lQqkhgDVPx7W2wk4BDhfmO8rFcN-0-697b0996f627f172806343359de343ba)
版图5-33 关闭盆腹膜,预防补片外露
1.膀胱反折腹膜 2.子宫浆膜
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0009_0006.jpg?sign=1739290479-Z81CHQwIrbRMBfWFA9JGzXy9wuBKUNdO-0-68de72cd32afbde85f44fd250ec1f4cc)
版图11-1 诺舒手术前宫腔镜下宫腔形态
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0001.jpg?sign=1739290479-h8atNHZ5o7bO29wXc1AZJTrkqPpKNGRk-0-3beb7a667e98936f1e8f42f5c1f20747)
版图11-2 舒展电极附于子宫内膜表面
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0002.jpg?sign=1739290479-49esLP8OIHOMPajUBXl7XEbzIvZto6j4-0-2f051df1e8d753344471d71fa29f027d)
版图11-3 CO2检测有无宫穿孔
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0003.jpg?sign=1739290479-tU7EQuiRFkBNw2N9joV2ZRAAzBm2eiLW-0-754b12913e2bea8a562fb71e7b6c2d0b)
版图11-4 诺舒网状电极传输能量切除子宫内膜
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0004.jpg?sign=1739290479-gKFty7UCsqnZgHygupghK8fp0NPfD59a-0-cc95770d088b0c627b53f5fc9b30948a)
版图11-5 术后宫腔表面
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0005.jpg?sign=1739290479-B2hxDqsobu35fgp8UziMnIX54TxBFmWr-0-c0cf6b82c30c8f08a6e76d6990c495c7)
版图11-6 子宫肌层渗透程度(子宫角:2~3mm;子宫体:5~7mm)
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0006.jpg?sign=1739290479-TvD3iQmSWYZrfkQ48hUUBVdoq3f8g6QR-0-6585c3c9201e0551542d2218ad98ee70)
版图11-7 诺舒手术后宫腔镜下宫腔形态
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0007.jpg?sign=1739290479-9uojPcsCUnxKfFNXzKZGavbtaODn5VkC-0-295e9af38f69ba0261d4c37fd5699a4a)
版图11-8 诺舒术后子宫内膜黏附在双极电极上
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0008.jpg?sign=1739290479-1hmMoQkrQqfuuH5GXKerN4MvR6cTlNdv-0-3413b043283570dfc03e9274e798f7af)
版图11-9 诺舒手术后子宫标本(子宫大小不同,肌层渗透程度不同,子宫破坏的深度一致)