腹腔镜与开腹全子宫切除术的比较

Clinical comparison of total laparoscopic hysterectomy with total abdominal hysterectomy

目的:比较腹腔镜全子宫切除术与开腹全子宫切除术的临床效果。方法:回顾性分析2006年7月-2008年3月我院腹腔镜子宫全切除术60例和传统子宫全切除术68例的临床资料,比较2种术式的术中出血量、排气时间、术后下床活动时间,住院时间、术后疼痛剂使用。结果:腹腔镜子宫切除术60例,术中出血量(120.3±30.4)ml,平均住院时间(5.6±0.7)d,术后排气时间平均(24.9±11.6)h,术后下床活动时间(23.2±5.7)h,腹腔镜组术后镇痛5例,切口全部甲级愈合,显著低于开腹子宫切除术组,两组比较差异有统计学意义(P<0.05)。结论:两种子宫全切除术术式各有其优势且不能完全替代,应根据病人情况、外科医生的技术水平和医院的条件综合考虑术式。腹腔镜组具有创伤小、出血少,腹腔内环境干扰小、恢复快、腹部无疤痕等优点。

Objective：To compare the clinical efficacy between total laparoscopic hysterectomy and total abdominal hysterectomy. Methods： Data of 60 cases with total Laparoscopic hysterectomy and 68 cases with total abdominal hysterectomy was retrospectively reviewed. The blood loss, time to first passing flatus, time to flint acting, length of hospital stay, and postoperative analgesic requirements were respectively compared between the two groups. Results：The laparoscopic group：blood loss （ 120.3 ±30.4） ml time to first passing flatus （24.9 ± 11.6） h time to first acting （23.2 ±5.7 ） h length of hospital stay （5.6 ± 0.7 ） d postoperative analgesic requirements （5 cases） fatty dissolution beneath the incision（0 case）. There were statistically significant differences betweem the 2 groups. Conclusion：Total laparoscopic hysterectomy and total abdominal hysterectomy have different adavantages, different kinds of hysterectomy shoud be chosen according to different patients and situation. Total laparoscopic hysterectomy offers less invasion, less interference to the abdominal organs, quicker postoperative recovery and no scar in the abdomen.