腹腔镜下两种子宫切除术的临床分析与比较

Clinical comparison to two different types of laparoscopic hysterectomy

目的探讨腹腔镜全子宫切除术(LTH)与腹腔镜辅助阴式子宫切除术(LAVH)2种术式的应用价值。方法选取2008年5月～2010年5月在本院行腹腔镜子宫切除手术的患者222例,其中LTH组85例、LAVH组137例,比较其出血量、手术时间、术后恢复排气时间、术后住院时间及并发症等情况。结果 LTH组术中出血量为(89.50±16.38)mL,明显少于LAVH组的(119.40±16.98)mL;手术时间LTH组为(158.00±5.87)min,明显长于LAVH组的(106.00±5.15)min,差异均具有统计学意义(P<0.05)。在手术后恢复排气时间、术后住院时间及手术并发症方面,两组差异无统计学意义(P>0.05)。结论 LTH和LAVH均是安全可行的术式,各有优缺点,LTH有成为子宫切除主要术式的趋势,应根据患者的具体情况及术者的熟练程度选择具体的方式。

Objective To compare the clinical effectiveness of laparoscopic total hysterectomy （LTH） and laparoscopic assisted vaginal hysterectomy（LAVH）.Methods The blood loss,operation time,days of hospitalization,recovery status,complications were compared between 85 cases of LTH and 137 cases of LAVH performed in Department of Obstetrics and Gynecology,the Clinical Medical College of Yangzhou University from May 2008 to May 2010.Results The estimated blood loss in group LTH（89.50±16.38） mL was less than group LAVH（119.40±16.98） mL;the average operation time in group LTH（158.00±5.87） min was longer than group LAVH （106.00±5.15） min,there was significant difference（P0.05）.There were no differences on the recovery after operation,complications and hospitalized days between the two kinds of operations. Conclusion LTH and LATH are safe and practicable operation methods.Both have pluses and minuses.LTH is effective and is recommended to be used widely.According to the disease,selecting the proper operation ways is the key to decrease complications and improve the safety of operation.