超声刀在腹腔镜全子宫切除术中的应用

Aplication of ultrasonic scalpel in laparoscopic hysterectomy

目的探讨超声刀在腹腔镜全子宫切除术中的临床应用价值。方法对2006年2月～2007年12月125例子宫肌瘤、子宫腺肌症以及宫颈CINⅢ级的患者采用腹腔镜下超声刀全子宫切除术。并以同期100例开腹全子宫切除术的患者作为对照组。结果所有125例病例均在腹腔镜下采用超声刀顺利完成,无中转开腹,无手术并发症。平均手术时间(85.8±23.6)min,平均估计失血量(95.5±14.4)mL。与开腹手术的手术时间(114.8±31.9)min和术中失血量(124.7±51.2)mL相比,明显缩短手术时间,减少出血量,P<0.05。结论超声刀腹腔镜全子宫切除术具有手术时间短、出血量少的优点,是安全、有效的手术方式。宫颈CINⅢ级是腹腔镜全子宫切除最佳适应证之一。

[Objective] To investigate the clinical value of ultrasonic scalpel in laparoscopic hysterectomy（LH）. [Methods] The records of 125 patients with myoma, adenomyosis or cervical intraepithelial neoplasia （CIN） III who underwent laparoscopic hysterectomy （LH） between 2006 and 2007 were reviewed. And 100 patients who underwent abdominal hysterectomy （AH） were recruited as control group. [Results] All the laparoscopic operation with ultrasonic scalpel were performed successfully. No case was converted to laparotomy and no complication was observed. The mean operating time was （85.8±23.6） min. The mean blood los was （95.5±14.4） mL. Comparied with AH group, the operation time were significantly shorter than that of LH group, and the blood lose was also less than that of LH group. P 〈0.05. [ Conclusion] The laparoscopic hysterectomy with ultrasonic scalpel has the advantage of shorter operation time and less blood los. It is a safe,effective surgery. CINIII is one of the best indication of LH with ultrasonic scalpel.