腹腔镜与开腹子宫全切术对机体影响的分析比较

Comparison of the Clinical Effects between Laparoscopic Hysterectomy and Transabdominal Hysterectomy

目的比较腹腔镜子宫全切术和开腹子宫全切术的临床效果。方法回顾性分析比较行子宫全切术的80例患者病例资料,其中行腹腔镜下子宫全切术40例(腹腔镜组),同期行开腹子宫全切术40例(开腹组)。比较两组的手术时间、术中出血量、术后排气时间、术后病率及术前、术后1 d血液白细胞计数、中性粒细胞百分比。结果与开腹组比较,腹腔镜组术中出血少、术后排气早、术后病率低(P<0.05);开腹组术后第1 d血白细胞计数和中性粒细胞百分数均较手术前显著升高(P<0.05),腹腔镜组与术前相比,差异无显著性(P>0.05);两组术后白细胞计数和中性粒细胞百分数相比,开腹组均高于腹腔镜组,差异显著(P<0.05)。结论腹腔镜下子宫全切术对机体创伤较小,免疫功能干扰小;临床可根据具体情况优先选用腹腔镜手术,以达到最佳治疗效果。

Objective To compare the effects of laparoscopic hysterectomy （LH） and abdominal hysterectomy （AH）. Methods 80 women underwent hysterectomy were analyzed retrospectively, including 40 performed LH （as LH group） and 40 received AH （as LH group）. The operative time, intraoperative blood loss, postoperative exhausting time, postoperative morbidity, white blood cell （WBC） and neutrophilic granulocyte rate one day before or after the operation were compared between the two groups. Results LH group had less intraoperative blood loss, shorter postoperative exhausting time and lower febrile morbidity than those of the AH group （ P 〈 0. 05 ）. The WBC count and the neutrophil granulocyte rate were increased significantly in AH group one day after surgery than those before surgery （ P 〈 0.05 ）, but not in LH group （ P 〉 0.05 ）. And comparing with the LH group, both the postoperative WBC count and the neutrophil granulocyte rate of the AH group were higher （P 〈 0.05 ）. Conclusion Laparoscopic hysterectomy has a more favorable clinical outcome, lower degree of immune suppression and less tissue trauma, is a safe and feasible technique for benign gynecologic disorder.