![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=1738855275-OXJLg5Npv0l0gFhfGU0buWHANLOnze16-0-10ea778c64c97ed6017853a4095a2a1d)
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=1738855275-ZfaKmoZnv4zt4Uat0Z6reJ1vxqSmPmxl-0-331474d0b70347772e31146a98f78420)
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=1738855275-bpCJSQEfuFBJwoVoS5Dhj7bCT4agZB9n-0-8c9d16de6074bdc57ec8458f010a6764)
版图4-2 插入气囊导管
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0003_0004.jpg?sign=1738855275-qkWmZ5Wa4TPI08thV9DE1cp1kIOvK9VE-0-805c56c6ed2d3f8282ba4b3bcc770db8)
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=1738855275-BFcm7nhHKrrA7oViU2LObgL96EJdIHBE-0-d8f7160ecd8944aec9a9f4ab9fd58473)
版图5-1
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0004_0001.jpg?sign=1738855275-XpZPyH9AZSYvMB1Yp6bETfsefIk1Wf9Y-0-8704ad46868494b4fe63ee9573e39ad4)
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=1738855275-uirs5pTiNhWlFAIyDk6wFnCLL4Ai0Zam-0-bcee959a56e92415d7d3e8f4e3357c71)
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=1738855275-COZH9ETPIhY8IioZRJQkJ9b5XqcijLSV-0-2d05fd38d3229ddc5b17edcd8f36a124)
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=1738855275-3GYxLDRXuesoeKyUoi93BySox4pjJPYr-0-55849870f931c70df2b9b7ad6879a717)
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=1738855275-m8MpumKxlT6z7OX3RaT2vRDvaUvyvk0s-0-0be3ce450796b0500a9d87f3710985f0)
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=1738855275-UVGkCEqX4GCHwaxwC08kW0BfVobDka9s-0-07ded910ee8768c1fc991a462a7b21f8)
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=1738855275-OnEckiGieJ64RSRXnISY9K2hMBbdTrym-0-96d574448251ddada10852e29b782cf4)
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=1738855275-9H2yoqBXfKtmOGosL686IHPNa4appjac-0-a1971dbc1c0d08eff62da47077a6178a)
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=1738855275-zIc0XuR2MsReAOXGP9UPnYVMCYkN4wnl-0-909de339488d99d8a2f803b417174bed)
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=1738855275-euiJlSlm4aztdepsIAH5vMEjGg21VjN4-0-3a39f10b4d7e798293c8151e8521b444)
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=1738855275-dOp2M1isawSs3br6PDxTByQB3N0bOjh2-0-3c6a85f1d7f78ed33094ea112515fb5c)
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=1738855275-CDFYjWyRntZBi20tx1sjvvQ4wUwLp2pH-0-579f82f80d1c217f9a4afb872368e240)
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=1738855275-8oTJnZCJZy3xvvot8ITQ5VxNTDHQXQV1-0-21a7ada28d0b2fc5bacf6dea9b5515a1)
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=1738855275-OeA2oOkJ8LkBMnn81ZPTIC610UtEMsK8-0-d69a07b879fec0da129d5f833deb588e)
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=1738855275-knDT8M2cseIvmo8QpEh99CtPbAzwAoCJ-0-da650b39b1a13d3c3e5098674a6448d3)
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=1738855275-U72wun0MBmrvTZ5SKUwwGW70NAax2vjL-0-516c28eb32f528838400e5510aa881ed)
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=1738855275-oBnUCh764x8EwRBkl0BVsmfaUPGnVzcg-0-aaea329df6613a312a836bd3578c0cf2)
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=1738855275-dDHc6yNaUpvpbOSUpu0WirT0IkURrUOi-0-a67a5e1916682385ae566c1d352e56d7)
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=1738855275-fuj31yffYxqicWad1tkcgozNGDxaQ3he-0-f69427f1959770c7a1a402aeda96ef77)
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=1738855275-lBaMpEpkqSWXoIAf8dkNWbRgX9DQLBlN-0-e5ad9ec591ef522fb1d43be71f379d42)
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=1738855275-RW0Ip1h0jKiccpuS90aSo01sURpyC2ls-0-c9bf9419cf1309927a5b5852b3c546ba)
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=1738855275-hacUCmbMfIQ4T4GWKd2rIQ9viJUCZj48-0-b12e4dd05696932064638516e64ca568)
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=1738855275-CXjjNWDFyraUNCPTa6RUks2pS8na6RyG-0-b68608248f486649d6b478921b056d6f)
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=1738855275-pMd5nxrW2JZcLk9AemfqSjGw8hDsdt9y-0-c6c35126caf9c651ea5659d6b1f85c0f)
版图5-25 横断宫颈
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0006.jpg?sign=1738855275-T0R0wV16GRWrU3JVugnXp8aF9zsJcLBc-0-2e1eaa1f9d030bb7ea3c533f76834cbe)
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=1738855275-1M6ZLbm2fYuwZbK08iVBCF7shFooQTxq-0-f8801a32716e65d2b3186de1014a9a1c)
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=1738855275-M80ces7KiJ6X9pAWrVasLSc6acWpx0Fa-0-c91af07df174791dc9f86e2189d2dfab)
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=1738855275-gxCjPOjPcQBYoC0rpX5xZClBK87vzmm5-0-2dbbbdd0f00ad8182fdda084dcfd004a)
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=1738855275-gCWbzttTxAGx6Z0lz9WLV9Q9aKQkdhiW-0-4228354e486b7025517694afebeda652)
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=1738855275-qNcUK28oFEFe7c9VgfHVf0fliByXwovg-0-34179c8de57771a69118e40b361b679d)
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=1738855275-shaDF5ZPFzK7i2UUo7i0wCXmZVtVUsf8-0-a36b274a40c6df3b9b6b324232674296)
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=1738855275-OwAgqlhhXPGQHtzJ4skGpfenWadxIMv9-0-6f6ef69c23b8d51dd5eed62c435c4e6e)
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=1738855275-scpU3gOEf914mgaBDq3joB7srDeKZmv7-0-7aeee7da94a4c581fa8be93a1f3d0587)
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=1738855275-jyVOJZCeTyMADgnU6k7LbuY8AT23TQjr-0-1573cdb3e02b739b03efbdf4df0bf103)
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=1738855275-WzvGuhgUIHlEXzOYxzocdrrIhdPjowLv-0-3c9c0fdc3a39caa2cb81a3fe480ae55d)
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=1738855275-OKf3WwJlKXmEA4iCuesDlhWbrre4SsW8-0-65ba6e1f216d0ac915b1d30d1b38e1e5)
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=1738855275-4oBXP5TsrRJATXUdJZAtC0nm59D1UoGV-0-11b85b632f247f506b1dacbdc5e1e650)
版图11-5 术后宫腔表面
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0005.jpg?sign=1738855275-wSpHQh02jQklO4fRsFAY0YN8aTl9rp6S-0-a602dbdeb7c989c252732382fc6aff92)
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=1738855275-f4RwCJyVcARHKjwMGPTLSPvPWKtP3xkW-0-bff2b727f4b64bf95084474aecc40e3f)
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=1738855275-zJAih6SUxgiggMHzD39Qguln9smD8Fpp-0-90955d991fda9485d740706dde6982ec)
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=1738855275-Gx4wMyxZk0hzK0XktA8MFribPve2zfhi-0-3f0f9db3bd898837c38d3a0438339142)
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)