腹腔镜与开腹次全子宫切除术比较研究

Comparative Study of Laparoscopic HysterectomyVersus Abdominal Hysterectomy

目的:探讨腹腔镜次全子宫切除与开腹次全子宫切除的优缺点。方法:80例因子宫肌瘤等需次全子宫切除的患者,根据患者意愿,分为腹腔镜组和开腹组,每组40例,分析2种手术的手术时间、出血量、术后病率、肠功能恢复、平均住院天数等情况。结果:腹腔镜组平均手术时间为45.5±10.6min,明显短于开腹组(51.64±10.2min),P<0.05;腹腔镜组平均出血量为95.7±20.2ml,明显少于开腹组(123.3±27.7ml),P<0.01;腹腔镜组术后病率为7.5%(3/40),明显少于开腹组的25.0%(10/40);腹腔镜组术后平均排气时间为21.5±2.2h,明显少于开腹组(28.9±4.7h),P<0.05;腹腔镜组术后平均住院时间为4.2±1.5d,明显少于开腹组(6.6±0.5d),P<0.01。术后6个月随访时,除开腹组有2例伤口愈合不良外,其余无并发症。结论:腹腔镜次全子宫切除较开腹的优势更趋明显,如果腹腔镜操作技巧熟练,在腹腔镜下进行次全子宫切除是一种理想的术式。

Objective： To study the advantages and disadvantages of laparoscopic hysterectomy and abdominal hysterectomy. Methods： Eighty cases who needed hysterectomy were divided into laparoscopic group （n=40） and abdominal group （n=40）. The operation time, the blood loss, complication and post-operation recovery of intestinal function and mean duration of hospitalization after the two operations were analyzed. Results： The operation time in laparoscopic group （45.5 ±10.6 min） was shorter than that in abdominal group （51.6±10.2 min） （/）〈0.05）. The blood loss in abdominal group（123.3±27.7 ml） was higher than that in laparoscopic group （95.7 ± 20.2 ml） （P〈0.01）. The postoperative temperature, recovery time of intestinal function, and duration of hospitalization in laparoscopic group and abdominal group were 7.5% （3/40） vs 25.0% （10/40）; 26.2 ± 4.2 h vs 28.87 _ 4.7 h （P〈0.05）; 4.2 ± 1.5 d vs 6.6 ± 0.5 d （P〈0.01）, respectively. They were followed for 1 month to 6 months, there were 2 cases for complication in abdominal group only. Conclusion： Laparoscopic hysterectomy is better than abdominal hysterectomy according to our result. Laparoscopic hysterectomy was an ideal operative style for hysterectomy.