改良腹腔镜筋膜内子宫切除术201例临床分析

The Clinical Analysis of 201 Newly-laparoscopic Intrafascial Supracervical Hysterectomy

目的:探讨改良腹腔镜筋膜内子宫切除术(CISH)的手术方法和临床效果。方法:回顾性分析201例改良CISH(研究组)及35例传统CISH(对照组)的临床资料及随访结果。结果:①两组中转开腹率均为3%。②研究组手术时间85.36±32.24分钟,少于对照组100.56±29.94分钟(P<0.05);研究组术中出血量50.62±44.23ml,少于对照组83.36±29.21ml(P<0.05);研究组术后排气时间22.29±3.42小时,短于对照组38.36±9.34小时(P<0.05);两组术后阴道流血时间、残端出血率及术后病率之间比较,差异无统计学意义(P>0.05)。③术后随访,研究组残留宫颈类似正常外观,对照组宫颈成实性组织。结论:改良腹腔镜筋膜内子宫切除术安全、可靠,具有术中出血少、手术时间短、术后恢复快并且术后有利于进行常规检查,发现病变等优点。

Objective： To explore the technical aspects and advantages of a newly intrafascial supracervical hysterectomy （CISH） in laparoscopic hysterectomy. Methods：We performed a retrospective evaluation of 201 women who underwent a new CISH （the study group） and 35 women （the control group） who did conventional CISH technique. Results：The rate transfer to transabdominal hysterectomy was 3% in two groups as severely pelvic adhesions. The women who underwent the new CISH had significantly shorter operating time （85.36±32.24 min） as compared to the conventional method （100.56±29.94 min）. The intraoperative blood loss of study group were 50.62±44.23 ml, shorter than control group （83.36 ± 29.21 ml） （ P 〈 0.05） ; and the anus venting time of study group were 22.29 ±3.42 hr, lower than that of the control group （38.36±9.34 hr） （ P〈0.05）. There was no significant difference in the postoperative bleeding time, the postoperative blood loss, and postoperative fever rate between two groups. Conclusions：Tbe new CISH technique is safer, more convenient, faster, and less blood loss than the conventional technique.