比较结扎速血管闭合系统与双极电凝在腹腔镜子宫切除术中的应用

Comparison on application of ligasure vessel sealing system and bipolar electric coagulation in laparoscopic hysterectomy

目的比较结扎速血管闭合系统(Ligasure)与普通双极电凝在腹腔镜子宫切除术中的应用效果及安全性。方法对80例子宫肌瘤拟行腹腔镜子宫切除术的患者,40例使用结扎速血管闭合系统凝固闭合卵巢和子宫血管,另外40例使用普通双极电凝术凝固闭合卵巢和子宫血管,比较两组间手术时间、术中出血量、术后恢复情况及近期术后并发症的发生情况。结果对凝固和闭合<3 mm管径的血管,两组的手术时间、术中出血量无明显差异(P>0.05);但对凝固、闭合3～5 mm直径的子宫、卵巢血管,Ligasure组的手术时间、术中出血量均显著少于双极电凝组,差异有统计学意义(P<0.01)。两组的术中术后并发症及术后恢复情况差异无统计学意义(P>0.05)。结论 Ligasure、普通双极电凝均能安全、有效地凝固<3 mm直径的血管,但在结扎速凝固闭合3～5 mm的较大血管时,使用Ligasure更安全、更有效,能减少出血量及缩短手术时间。

Objective To compare the effects and safety of hgasure vessel sealing system and bipolar electric coagulation in laparoscopic hysterectomy. Methods The clinical data of 80 patients with myoma of uterus who had put laparoscopic hysterectomy were retrospectively analyzed. In 40 patients received laparoscopic hysterectomy, li- gasure vessel sealing system was applied to occlude the ovarian and uterine vessels, in another 40 patients used bipo- lar electric coagulation. The operation time ,intra-operative blood loss, recovery condition after the operation and post- operative early comphcations were compared. Results Both ligasure and bipolar electric coagulation could effectively coagulated the vessels smaller than 3mm, their operation time and intra-operative blood loss were similar. But there were significant differences between two methods in the occlusion effects on ovarian and uterine vessels whose diame- ters were 3 - 5 mm. Both of them recovery condition after the operation and postoperative early complications were similar. Conclusion Ligasure and bipolar electric coagulation could effectively coagulate the vessels whose diameters are 〈 3 mm. Ligasure can occlude the large vessel （3 - 5 mm） more safely and effectively than bipolar electric coagulation. Ligasure can reduce the intra-operative blood loss and shorten the operation time.