单、双极电凝在腹腔镜下全子宫切除术中的应用

Application of Monopolar and Bipolar Electrocoagulation in Laparoscopic Hysterectomy

目的探讨单、双极电凝在腹腔镜下全子宫切除术中的可行性及安全性。方法将128例有腹腔镜全子宫切除术指征的患者按随机数字表法分为2组,单双极电凝组和双极电凝组,每组64例。对2组患者的手术时间、术中出血量、并发症、住院时间以及预后情况进行比较。结果单双极电凝组手术时间为(72.64±6.72)min,双极电凝组为(89.12±10.23)min,2组比较差异有统计学意义(P<0.05),单双极电凝组术中出血量为(78.70±26.26)mL,双极电凝组为(98.23±27.89)mL,单双极电凝组的术中出血量明显少于双极凝血组(P<0.01);2组术中并发症、住院时间、预后情况等比较差异均无统计学意义(均P>0.05)。结论联合使用单、双极电凝于腹腔镜全子宫切除术是安全、可行的;只要掌握单、双极电凝的操作技巧,手术时间可明显缩短,出血量减少。

Objective To study the feasibility and safety of monopolar and bipolar electrocoagulation in laparoscopic hysterectomy.Methods One hundred and twenty-eight patients underwent laparoscopic hysterectomy were randomly divided into two groups,with 64 patients in each group.Monopolar electrocoagulation and bipolar electrocoagulation were used in monopolar and coagulation group,and bipolar electrocoagulation was used in bipolar coagulation group only.The operation time,intraoperative blood loss,complication,length of hospital stay and prognosis were observed in the two groups.Results The mean operation time was（72.64±6.72）min and（89.12±10.23）min in monopolar and coagulation group and bipolar coagulation group,respectively,and there was a significant difference between the two groups（P0.05）.The intraoperative blood loss in monopolar and coagulation group was less than that in bipolar coagulation group[（78.70±26.26）mL vs（98.23±27.89）mL,（P0.01）].There were no significant differences in length of hospital stay and prognosis between the two groups（P0.05）.All 128 cases were successfully treated without complication.Conclusion Satisfactory results can be obtained by mastering surgical methods of electrocoagulation.Application of monopolar and bipolar electrocoagulation in laparoscopic hysterectomy is safe and feasible,and may shorten the operation time and reduce the cost of operation.