三种途径全子宫切除术对比

Comparison on the mode of hysterectomy through three kinds of approach

目的探讨经腹全子宫切除术(TAH)、腹腔镜铺助阴式全子宫切除术(LAVH)及阴式全子宫切除术(TVH)三种手术方式优缺点及临床应用。方法对92例全子宫切除术的患者分别采用以上三种不同手术方法,然后统计其手术时间、术中出血量、术后排气时间、下床活动时间、术后病率、住院天数、镇痛剂应用及住院费用。结果三组手术方法中,术后排气时间、下床活动时间、术后病率、住院天数、镇痛剂应用及住院费用差异有统计学意义(P<0.01),而三种手术方法手术时间及术中出血量差异无统计学意义(P>0.05)。结论TVH、LAVH具有安全性好、创伤小、痛苦少、术后恢复快等优点,临床应用时可依据条件,首选TVH,LAVH作为次选,最后选TAH。

Objective To compare the clinical advantages and disadvantages of therapeutic efficacy during application of three kinds of operative methods of total abdominal hysterectomy（ TAH ）, vaginal hysterectomy （VH） and total laparoscopic hysterectomy（TLH）. Methods Hysterectomies in 92 patients were performed by three different approaches（TAH,LAVH and TVH）, then their duration of operation, the hemorrhage quantity in operation, the time of air exhaust after operation, the time of ambulation, in morbidity rate after operation, anodyne application, number of days in hospitalization and hospitalization expenditure were analyzed statistically. Results Significant differences existed in duration of operation, the time of air exhaust after operation, the time of ambulation and number of days anodyne application and hospitalization expenditure in hospitalization among three approa- ches of hysterectomy（ P 〈 0. 01 ）. There was no obvious difference in duration of operation or hemorrhage quantity of operation among three approaches （ P 〉 0. 05 ）. Conclusion LAVH and TVH show several advantages, including good safety, less trauma, less pain and quick recovery;but the choice of operation should be made according to the actual condition of patients. Usually, choose TVH at first,often place LAVH on the second,TAH is the last choice.