腹腔镜下全子宫切除术的临床评估

The Clinical Value of Total Laparoscopic Hysterecto my

目的：对腹腔腔镜下全宫切除的临床价值进行评估。方法：对４３ 例因诊断为子宫肌瘤（３３ 例） 、子宫腺肌症（６例） 及子宫内膜增殖症（４ 例） 的患者行腹腔镜下全子宫切除术，对同时期１２１ 例具有同样适应症的患者行腹式全子宫切除手术。比较两组病人术中术后情况。结果：两组病人的手术时间、术中出血量无显著性差异，腹腔镜下全子宫切除术的手术时间与子宫增大有关，术中出血量与手术时间及子宫大小无关；行腹腔镜下全子宫切除术的病人手术损伤及术后阴道残端出血发生率无增高，术后疼痛的发生率明显减少，术后使用抗菌素时间、术后住院时间及术后恢复正常活动的时间缩短。结论：腹腔镜下全子宫切除术虽不能完全代替腹式全宫切除术，却是一种安全、可靠，适于临床广泛开展的手术方式。

Objective : To investigate the clinical value of classic abdominal S E M M hysterectomy ( C A S H) . Meth ods : Forty three cases of C A S Hcompared with 121 cases oftotal abdominal hysterectomy ( T A H) ,with both indicationsincluding uterine myomas ,adenomyosis and endometriosis . Results : Both the average operating time and estimated bloodloss of cases of C A S H were no significantly more than those of cases of T A H. In the cases of C A S H,there were signifi cantcorrelations between operating time and specimen weight ,butthere were no significant correlations between estimatedblood loss and operating time or specimen weight. The intraoperative complications and postoperative complications ofcases of C A S H were no significantly increased . In the cases of C A S H,the time of using antibiotic the time ofand hospi talization in the were storter quicker returning . It was to normal activity ,and less postoperative pain . Conclusions: Al though it can replace T A Hcomplitely , C A S His a safe ,reliable method ofremoving uterus and can be performed widely .