腹腔镜辅助下的阴式子宫切除临床分析

The Clinical Analysis of Laparoscopic Assisted Vaginal Hysterectomy

目的探讨腹腔镜辅助下的阴式子宫切除的临床价值。方法选择2009年2月至2011年2月间于长沙市第四医院行子宫全切的患者130例,年龄25～67岁,平均43.9岁。根据手术方式的不同将其分为3组,第一组患者36例,行LAVH(腹腔镜辅助下阴式子宫切除术),第二组患者48例,行TAH(开腹子宫切除术),第三组患者46例,行TVH(经阴道子宫切除术)。比较三组患者手术平均时间、术中出血量、术后肛门排气时间、下床活动时间、平均术后住院时间及术后并发症情况。结果与TAH组相比,LAVH组及TVH组患者手术平均时间、术后肛门排气时间、下床活动时间、平均术后住院时间明显缩短,术中出血量显著减少,均存在统计学差异(P<0.05)。TVH组患者手术平均时间比LAVH组的明显缩短,二者间有统计学差异(P<0.05)。LAVH组中有3例患者出现术后并发症,占8.33%,较其他两组低,但无统计学差异(P>0.05)。结论腹腔镜辅助下的阴式子宫切除术效果好,并发症少,患者术后恢复快,是一种较理想的手术方法。

Objective To investigate the clinical value of laparoscopic assisted vaginal hysterectomy.Methods 130 patients who accepted hysterectomy in the Forth Hospital of Changsha from February 2009 to February 2011 were chosen,Aged 25-67 years,mean 43.9 years old.They were divided into 3 groups according to the different surgical procedures,The first group had 36 patients,LAVH（Laparoscopic assisted vaginal hysterectomy）were performed,The second group had 48 patients,TAH（Transabdominal hysterectomy）were performed,The third group had 46 patients,TVH（Transvaginal hysterectomy） were performed,The mean operative time,blood loss,anal exhaust time,ambulation time,mean postoperative hospital stay and postoperative complications of the three groups were compared.Results Compared with TAH group,the mean operative time,anal exhaust time,ambulation time,mean postoperative hospital stay of LAVH group and TVH group were much short,The blood loss were much less,There were statistically significant difference（P〈0.05）.The mean operative time of TVH group was significantly shorter than the LAVH group,There were statistically significant difference（P〈0.05）.In the LAVH group,3 patients had postoperative complications,accounting for 8.33%,It was lower than the other two groups,but had no significant difference（P〉0.05）.Conclusions Laparoscopic assisted vaginal hysterectomy has good effect,fewer complications,faster postoperative recover,is an ideal surgical method.