腹腔镜较大子宫切除术89例临床分析

Clinical analysis of laparoscopic total hysterectomy for large uterus

目的探讨腹腔镜进行较大子宫全切术的子宫取出方式对临床预后的影响。方法将腹腔镜下较大子宫(≥3个月妊娠子宫大小)全切术89例分成经腹腔镜碎宫器取出(A组,49例)及经阴道取出(B组,40例),观察两组患者的手术时间、术中出血量、术后住院时间及并发症等。结果两组手术时间、术中出血量及术后住院时间差异均无显著性(P>0.05),而术后并发症(主要为晚期阴道流血)A组为1/49例,5/40例,两组比较差异有显著性(P<0.05)。结论在进行腹腔镜较大子宫切除术中,子宫的取出方式用碎宫器取出优于经阴道取出。

【Objective】To investigate two different ways of taking out the uterus after laparoscopic hysterectomy（LTH） for large uterus.【Methods】89 patients whose uteruses bigger than 3 months gestational uterus were random-ly assigned to two groups.All the patients were treated with LTH and the tissues were taken out from vagina or mor-cellated using an electronic morcellator.Duration of time,intraoperative bleeding and postoperative hospitalization and complications were compared.【Results】There was no significant difference on duration of time,intraoperative bleeding and postoperative hospitalization（P 0.05） but there was significant difference on postoperative complica-tions（late vaginal bleeding）（P 0.05）.【Conclusions】LTH for large uterus is feasible and safe,the tissues taken out by morcellator is preferred.