经阴道与腹腔镜全子宫切除术治疗子宫肌瘤的对比分析

Comprative Study Between Total Laparoscopic Hysterectomy and Vaginal Hysterectomy in the Treatment of Uterine Myoma

目的 :比较腹腔镜下全子宫切除术 (TLH)和经阴道全子宫切除术 (TVH)治疗子宫肌瘤的临床疗效 ,为子宫肌瘤的术式选择提供指导。方法 :我科 2 0 0 2年 2月～ 2 0 0 4年 3月共有 112例患者因子宫肌瘤而行全子宫切除 ,其中 6 4例行TVH ,4 8例行TLH ,两组病例术前一般情况相似。回顾分析两组病例的临床资料 ,比较两组手术时间、术中出血量、术后恢复情况等指标。结果 :TLH组手术时间平均为 (80 6 7± 14 8)min,TVH组为 (5 0±13 8)min ;TLH组术中出血量平均为 (134± 6 3 2 )ml,TVH组为 (80 0± 33 81)ml;TLH组手术费平均为180 0元 ,TVC组为 5 2 5元 ;TLH组术后肛门排气时间平均为 (2 1 3± 5 6 3)hr,TVH组为 (2 4 80± 2 5 3)hr;术后3hr疼痛评分TLH组平均为 (2 33± 1 76 )分 ,TVH组为 (6 80± 3 0 1)分 ;此 4项指标在两组间的差异有统计学意义 (P <0 0 5 )。术后 2 4小时及 4 8小时疼痛评分、术后病率、术后最高体温以及术后住院时间两组差异无统计学意义。结论 :对于单纯性全子宫切除术 ,TVH组在手术时间、术中出血、手术费用。

Objective:To compare the clinical results of total laparoscopic hysterectomy(TLH)and trans-vaginal hysterectomy(VH),and to provide valuabe information for choosing surgical treatment of uterine myoma.Method:One hundred and twelve women with uterine myoma underwent hysterectomy from February 2002 to March 2004 were collected,included 64 VH and 48 TLH.The preoperative general condition of the two groups was comparable.The clinical data of the two groups were analyzed.And the operating time,blood loss,postoperative recovery for both procedures were compared.Results:The mean operating time was (80.6±14.8)min for TLH group and 50+13.8min for VH group.The mean blood loss was 134+63.2ml for TLH group and 80.0+33.81ml for VH group.The mean hospital cost was $1800 for TLH group and $525 for VH group.The mean time of bowel function recovery was 21.3+5.63 hrs for TLH group and 24.80+2.53hrs for VH group.The postoperative pain score(3hr post-operation)was 2.33+1.76 for TLH group and 6.80+3.01 for VH group.There were significant differences between the operating time,blood lost,hospital cost,and the time of bowel function recovery after TLH and VH.There wre no significant difference between the postoperative pain score,morbidity,the highest temperature and hospital stay after TLH and VH.Conclusion:The results suggested that VH was preferable if the operating times,blood lost,hospital cost and abdominal wound were considered.