腹腔镜下筋膜内子宫切除术72例临床分析

Clinical study on total laparoscopic intrafascial hysterectomy in 72 cases

目的对腹腔镜下筋膜内全子宫切除术的临床疗效进行研究,证实该疗法确切的临床价值。方法以笔者所在医院2010年9月～2012年8月行全子宫切除术的144例患者为研究对象,将其随机分为两组,一组使用腹腔镜筋膜内子宫切除术,为观察组;一组使用腹腔镜下全子宫切除术,为对照组。对两组研究对象的临床数据进行比较及统计学分析。结果在手术时间和术中出血量的比较中,观察组与对照组比较差异有统计学意义(P<0.05);在住院时间、发热、排气时间及转为开腹手术的病例数等数据的比较中,观察组较对照组有显著优势,且差异有统计学意义(P<0.05)。结论腹腔镜下筋膜内全子宫切除术较腹腔镜下全子宫切除术具有损伤小、出血少、并发症发生率低、康复快等优势,是目前子宫手术方式中较理想的手术方式,具有重要的临床推广价值。

Objective To investigate the clinical outcome ot total laparoscoplc intrafasclal hysterectomy and demonstrate the exact clinical value of the therapy. Methods Between Sep.2010 and Aug.2012,114 patients undergoing total hysterectomy in our hospital were studied.All subjects were randomly divided into two groups, with ones undergoing total laparoscoplc intrafascial hysterectomy as the observation group and the others undergoing total laparoscopic hysterectomy as the control group.The clinical data of the subjects in two groups were compared and analyzed statistically. Results In the comparison on length of operation and amount of intraoperative blood loss,the difference between observation group and control group was statistically significant（P 〈 O.05）;In the comparison on length of hospitalization,postoperative fever, the time of first anal exsufflatiQn and the number of cases converting into undergoing abdominal hysterectomy,the observation group had more advantages than the control group and the difference was statistically significant（P〈 0.05）. Conclusion Compared with total laparoscopic hysterectomy,total laparoscopic intrafascial hysterectomy has advantages of tess trauma, fewer blood losses,lower incidence of complications and quicker convalescence. Currently,it is an ideal method in hysterectomy and has important clinical value for spread.