三种子宫切除手术的临床分析

Comparison of Three Operations for Hysterectomy

目的探讨子宫良性疾病经腹子宫切除术(TAH)、经阴道子宫切除术(VH)和腹腔镜辅助下阴式子宫切除术(LAVH)的临床效果。方法回顾性分析比较TAH50例、VH50例、LAVH52例的临床病例记录,包括手术时间,术中出血量,术中、术后并发症和术后肛门排气时间、术后住院日。结果手术时间TAH(95.00±14.6)min,VH(68.00±12.5)min,LAVH(65.00±12.6)min;术中出血量TAH(220.00±58.9)ml,VH(150.00±46.0)ml,LAVH(142.00±43.0)ml,术后肛门排气时间TAH(30.8±6.0)h,VH(18.5±7.5)h,LAVH(19.8±7.7)h,术后住院日TAH(6.5±1.5)d,VH(3.5±0.5)d,LAVH(3.2±1.5)d,VH和LAVH两组比较,差异无显著性(P>0.01),VH组和LAVH组平均手术时间显著短于TAH组,术中出血量较TAH组显著减少,术后肛门排气时间与术后住院日较TAH组明显缩短,差异有显著性(P<0.01)。结论LAVH、VH符合微创手术原则,具有手术时间短、对患者损伤小、术后恢复快,术后住院时间短的优点。

Objective To compare the clinical outcomes of total abdominal hysterectomy （ TAH ）, vaginal hysterectomy （ VH ）, laparoscopic assisted vaginal hysterectomy （ LAVH ） in short term. Methods Intraoperative and postoperative characteristics of 50 patients undergoing TAH,50 patients undergoing VH and 52 patients undergoing LAVH were analyzed retrospectively, including surgery time, blood loss, complications and postoperative hospitalizing days. Results Mean time of surgery was significantly longer for TAH than VH and LAVH （ P 〈 0.01 ）. Blood loss in operation was significantly smallerer for VH and LAVH than TAH（ P 〈0. 01 ）. Mean postoperative stay in hospital was significantly longer for TAH than VH and LAVH（ P 〈0. 01 ）. Conclusion Compare to TAH,LAVH and VH are effective hysterectomia modality. Less damage and recover quickly are their feaures.