微创与传统子宫切除术疗效比较

Comparing the Effect of Hysterectomy by Microtrauma and Traditional Way

目的：比较及评价用不同微创术式行全子宫切除术的临床效果。方法：回顾性分析自2004年2月-2006年8月的4年期间，我院第一第二临床学院妇产科所处理的328例良性子宫病变患者的资料。其中阴式全子宫切除术88例，腹腔镜下全子宫切除术122例，开腹组118例。对比分析了不同微创术式手术一般情况、术中出血量、术后并发症、随访情况及优缺点。结果：阴式组及腹腔镜组平均住院时间、平均术后病率及恢复时间均明显低于开腹组（表2）。3种术式各有其主要优点和适应证。腹腔镜最突出的优点是疼痛轻、出血少及恢复快，尤其腹腔镜下操作，视野清楚，对合并有盆腔粘连和附件包块者尤为适合。结论：各种术式的微创手术行子宫切除，各具有其利弊和相应的适应证。术中出血量多少、手术时间长短及是否有并发症与手术者的技术、仪器设备及患者条件，如子宫大小及是否有盆腔粘连等因素有密切关系。在决定手术方式时，慎重考虑各种术式利弊及上述相关因素，避免并发症的发生，是手术成功的关键。

Objective： Comparing the clinical effect of hysterectomy by different microtrauma operation ways; Methods： Analyzing the 328 cases with benign womb pathological changes from February 2004 to August 2006 retrospectively, then comparing the bleeding, complication after different microtrauma operation; Results： Three ways have their respective advantage and adaptive disease. The prominent advantage of celioscope is light pain, few bleeding and recovery quickly; Conclusion： The amour of bleeding, the time of operation and complication are related with the operation technology, instrumenttation and patients＇ condition, so we should think the advantages and disadvantages of every operation ways and aviod the complication, which are the key of operation success.