腹腔镜辅助下经阴式子宫切除术联合阴道前后壁修补在子宫脱垂患者中的应用效果

Effect of Laparoscopic Assisted Transvaginal Hysterectomy Combined with Anterior and Posterior Vaginal Wall Repair in Patients with Uterine Prolapse

目的分析腹腔镜辅助下经阴式子宫切除术(LAVH)联合阴道前后壁修补对子宫脱垂患者的影响。方法选取2020年6月—2023年6月滕州市妇幼保健院收治的74例子宫脱垂患者为研究对象,按随机数字表法将其分为对照组和观察组,各37例。对照组行传统LAVH联合阴道前后壁修补术,观察组行腹腔镜辅助下LAVH联合阴道前后壁修补术。对比两组围术期指标、应激反应指标及并发症发生情况。结果观察组术中出血量为(23.84±4.29)m L,少于对照组的(46.95±6.31)mL,手术时间为(67.52±6.15)min,住院时间为(5.20±1.04)d,均短于对照组的(85.49±7.34)min、(7.19±1.83)d,并发症发生率为5.41%,低于对照组的21.62%,组间差异有统计学意义(P<0.05)。观察组术后的去甲肾上腺素为(253.42±25.31)pmol/L,肾上腺素为(209.72±14.52)pmol/L,皮质醇为(185.33±20.35)nmol/L,均低于对照组的(309.87±28.63)pmol/L、(257.85±19.43)pmol/L、(205.97±23.54)nmol/L,组间差异有统计学意义(P<0.05)。结论腹腔镜辅助下LAVH联合阴道前后壁修补术具有创伤小、手术时间短、并发症少等优势,能够减轻应激反应,存在一定的应用价值,值得临床推广应用。

Objective To analyze the effect of laparoscopic assisted transvaginal hysterectomy(LAVH)combined with vaginal anterior and posterior wall repair on patients with uterine prolapse.Methods A total of 74 patients with uterine prolapse admitted to Tengzhou Maternal and Child Health Hospital from June 2020 to June 2023 were selected as the research objects,and randomly divided into a control group and an observation group,with 37 cases in each group.The control group underwent traditional LAVH combined with vaginal anterior and posterior wall repair surgery,while the observation group underwent laparoscopic assisted LAVH combined with vaginal anterior and posterior wall repair surgery.Compare perioperative indicators,stress response indicators,and complications between two groups.Results The intraoperative blood loss in the observation group was(23.84±4.29)mL,lower than(46.95±6.31)mL in the control group,with a surgical time of(67.52±6.15)min and a hospital stay of(5.20±1.04)d,which were shorter than(85.49±7.34)min and(7.19±1.83)d in the control group,and the incidence of complications was 5.41%in the observation group,lower than the control group's 21.62%,and the differences between the groups were statistically significant(P<0.05).The postoperative norepinephrine in the observation group was(253.42±25.31)pmol/L,adrenaline was(209.72±14.52)pmol/L,and cortisol was(185.33±20.35)nmol/L,which were lower than the control group's(309.87±28.63)pmol/L,(257.85±19.43)pmol/L,and(205.97±23.54)nmol/L,and the differences between the groups were statistically significant(P<0.05).Conclusion Laparoscopic assisted LAVH combined with vaginal anterior and posterior wall repair has advantages such as minimal trauma,shorter surgical time,and fewer complications.It can alleviate stress reactions and has certain application value,which is worthy of clinical promotion and application.