腹腔镜下子宫三角形切除不同术式阻断子宫动脉的临床应用

The comparison research of Laparoscopic uterine artery occlusion by multiple methods of uterine triangle excision

目的探讨腹腔镜下子宫三角形切除术中三种方式阻断子宫动脉的不同临床价值及应用效果。方法对997例患者分别行腹腔镜下子宫三角形切除术,术中采用丝线或钛夹结扎、双极碳化和红尿管捆扎三种不同方式阻断子宫动脉,比较3组病人术中、术后情况。结果 3组病人的手术时间、术后疼痛发生率、术后使用抗生素时间、体温升高、肛门排气时间、术后下床活动时间和术后住院时间均无差异(P>0.05)。手术时间、术中出血量红尿管捆扎组较丝线结扎、双极碳化组显著增加(P<0.05),丝线结扎、双极碳化组术后性生活恢复时间均较红尿管捆扎组延长(P<0.05)。3组均无手术并发症发生。结论腹腔镜下子宫三角形切除术是安全可行的,3种阻断子宫动脉方式各有其优缺点,应根据病人的具体情况选择具体的子宫动脉阻断方式。

Objective To discuss the different clinical value and application effect of laparoscopic resection of uterine triangle by three ways to uterine artery occlusion. Methods 997 cases, which were performed laparoscopic uterine triangular resection, three different methods of preoperative uterine artery occlusion （thread or titanium clip ligation, bipolar carbonation, red Foley catheter） were used to compare the intraoperative and postoperative conditions in three groups of patients. Results No significant difference was found in three groups of patients with operation time, postoperative pain, postoperative incidence of antibiotic use time, elevated body temperature, anal exhaust time, postoperative ambulation time and postoperative hospital stay. The operation time, bleeding volume in operation red Foley catheter banding group were significantly increased compared to silk ligature and bipolar carbonization groups. The three groups have no operation complication. Conclusion Laparoscopic uterine triangular resection is safe and feasible, three uterine artery occlusion methods have their own advantages and disadvantages, it should be based on the patient＇s specific circumstances to choose specific uterine artery occlusion.