超声刀在腹腔镜下子宫切除术中的应用分析

The application of ultrasound knife in the laparoscopy hysterectomy

目的通过腹腔镜下应用超声刀行子宫切除术，分析其临床价值。方法研究组使用超声刀对98例子宫良性病变需切除子宫者行腹腔镜下超声刀筋膜内子宫切除术。对照组使用单、双极电凝对86例子宫良性病变患者行腹腔镜下超声刀筋膜内子宫切除术，分别对2组手术时间、术中出血量、手术后体温、术后白细胞计数及血红蛋白浓度的均数进行比较。结果全部患者手术经过顺利，无并发症。研究组手术时间、术中出血量、手术后体温、术后白细胞计数及血红蛋白浓度分别为（86±38）min、（62±12）ml、（37．8±0．2）℃、（5．3±2．6）×10^9、（118±11）g／ml，与对照组分别为[（120±35）min、（91±21）ml、（38．9±0．9）℃、（9．0±4．2）×10^9、（102±12）g／ml]比较，差异有统计学意义（P〈0．05）。术后进行1—6个月的随访，均无慢性腹痛及胃肠功能紊乱等现象出现。所有患者的宫颈外鞘恢复近似正常。盆腔组织质地柔软，性生活满意。结论超声刀具有组织损伤小、少烟、少结痂、一剪多用等优势，是一种实用性强、值得普遍推广的腹腔镜手术器械。

Objective To analyze the clinical value of the ultrasound knife in the laparoscopy hysterectomy. Methods The research group included 98 cases with the uterine benign diseases who had the hysterectomy with classical intrafascial supracervical hysterectomy （CISH）. Meanwhile, the controlled group included 86 cases of the volunteer receiving CISH. Data of intra-operative blond loss, operative room time, operative body temperature, leukocyte count, and hemoglobin concentration were observed. Results The operation time, bleeding volume, body temperature after surgery, postoperative white blood cell count and hemoglobin concentration in research group were （86 ± 38）min, （62 ± 12）ml, （37.8 ±0.2）℃, （5.3 ± 2.6 ） × 10^9, （118 ± 11 ）g/ml, respectively; the controlled group were （ 120 ± 35 ） min, （91 ± 21 ） ml, （38.9 ±0.9） % , （9.0 ± 4.2） × 10^9, （ 102 ± 12） g/ml, respectively. After 1 to 6 months of follow-up, there was no chronic abdominal pain and gastrointestinal disorders occurred. All patients were recovered and satisfied in sexual intercourse. Conclusions The ultrasound knife has a variety of advantages, including less smoke, less scab as well as less fenestration damage.