腹腔镜全子宫切除术中子宫血管的处理

Efficacy of laparoscopic hysterectomy with different operative method on uterine vessel

目的探讨腹腔镜下全子宫切除术中子宫血管处理的方法。方法回顾分析148例腹腔镜下两种不同子宫血管处理方式应用于全子宫切除术的资料,比较两组的手术时间、术中出血量、术后恢复情况。结果 152例患者中有4例中转开腹,其余148例均在腹腔镜下完成,无一例手术并发症发生。子宫血管缝合组平均术中出血量和术后肛门排气时间分别为(81.72±27.61)ml和(20.45±3.78)h,电凝组分别为(125.82±48.15)ml和(35.78±6.46)h,血管缝合组比电凝组术中出血少,术后肛门排气快,差异有统计学意义(P<0.01,P<0.05)。结论腹腔镜全子宫切除术中子宫血管缝扎术可减少术中出血,有较高的临床应用价值。

Objective To explore the operative method on uterine vessel in laparoscopic total hysterectomy.Methods The data of 148 cases were retrospectively analyzed and compared among the different operative methods on uterine vessel of laparoscopic total hysterectomy regarding mean operative time,mean blood loss and complication rate.Results 148 cases were operated successful by laparoscopy.The mean blood loss and the days of postoperative exhaust via anus in suture group were（81.72±27.61）ml and（20.45±3.78）h respectively,while those in electro-coagulation group were（125.82±48.15）ml and（35.78±6.46）h respectively.The advantage of low blood loss,fast postoperative exhaust via anus were observed in suture group compared with that in electro-coagulation group,and the results showed that there existed significant difference between these two groups（p0.01,p0.05）.Conclusion Suture of uterine vessel in laparoscopic total hysterectomy can reduce blood loss,which has a higher clinical value.