妇科腹腔镜手术与传统开腹手术的比较研究

COMPARATIVE STUDY BETWEEN THE GYNECOLOGICAL LAPAROSCOPIC OPERATION AND TRADITIONAL LAPAROTOMY OPERATION

目的对妇科腹腔镜手术与传统开腹手术进行临床比较,探讨腹腔镜手术的适应症及其优越性。方法选取妇科腹腔镜手术患者110例(腹腔镜组)和传统开腹手术患者120例(开腹组),分别对两组患者术中及术后的一些定量及定性指标进行比较分析。结果腹腔镜组与传统开腹组患者的手术时间及术中出血量分别为(47.82±11.60)min、(35.75±8.42)min;(38.64±21.95)ml、(88.16±51.32)ml,差异有统计学意义(P<0.05)。腹腔镜组患者110例中,出现严重胃肠反应11例,占10%;出现严重疼痛7例,占5.8%;传统开腹组患者120例中,出现严重胃肠反应24例,占20%,出现严重疼痛60例,占50%,差异有统计学意义(P<0.05)。腹腔镜组与传统开腹组患者术后下床活动时间、胃肠功能恢复时间及术后住院时间分别为(9.54±1.87)h、(13.01±2.19)h;(4.88±165)h、(6.87±2.06)h;(5.36±0.80)d、(6.22±1.11)d,差异有统计学意义(P<0.05)。结论腹腔镜手术较传统开腹手术具有创伤小、痛苦轻、恢复快、腹部美观等优点,值得临床推广应用。

Objective To compare the gynecological laparoscopic operation and traditional laparotomy one and investigate the advantages and indexes of the gynecological laparoscopic operation. Methods In this study, we randomly divided two groups： laparoscopic group （n = 110） and laparotomic group （n = 120）. The intraoperative and postoperative indexes were observed respectively. These indexes of the two groups analyzed by SPSS i 1.5 software. Results The results showed that operative time of the two groups were 47.82 ± 11.60 min and 35.75± 8.42min respectively; and the bleeding volume was 38.64 ± 21.95 ml and 88.16 ±51.32 ml respectively; both of them showed statistical differences （ P 〈 0.05 ）. There were 11 cases of serious gastrointestinal reactions and 7 cases severe abdominal pain stamp of holes in laparoscopic group （110 cases） ,occupied 10% and 5.8% respectively; of 120 patients in laparotomy group, 24 cases showed serious gastrointestinal reactions （20%） and 60 cases severe abdominal incision （50%）. The difference was significant （ P 〈 0.05 ）. All of the patients among laparoscopic group and the conventional laparotomy group were out of bed activity, 9.54± 1.87h and 13.01 ±2.19h respectively ; Gastrointestinal function recovery time was 4.88 ±165 h and 6.87 ± 2.06h respectively, ; postoperation hospitalization time was 5.36± 0.80d and 6.22 ± 1.11 respectively, the difference was significant （ P 〈 0.05 ）. Conclusion Laparoscopy operation has less injury and pain, rapid recovery and maintains original shape of abdomen than traditional surgery and is worth of clinical application.