腹腔镜辅助阴式子宫切除术57例临床分析

Clinical Analysis of 57 Cases of laparoscopically assisted vaginal hysterectomy( LAVH)

目的探讨腹腔镜辅助阴式子宫切除术(LAVH)的临床应用情况,为患者做出最佳术式选择。方法回顾性分析2009年1月-2011年2月期间行LAVH手术的患者57例(LAVH组),并与同期开展阴式子宫切除术(TVH)的患者52例(TVH组)的临床应用情况进行比较、分析。结果 LAVH组平均手术时间长于TVH组,住院费用高于TVH组,差异均有统计学意义(P<0.05)。但2组术中出血量以及术后镇痛率、下床时间、肛门排气时间、住院时间、并发症发生率比较差异均无统计学意义(P>0.05)。结论 LAVH与TVH均为目前常用的微创手术方式,具有疼痛轻、恢复快、住院时间短等优点,适于盆腔黏连较重及需探查盆腔的患者。根据患者疾病种类及自身条件选择术式,增加了手术安全性。LAVH具有开腹手术及阴式手术共同的优点,其扩大了TVH的适应证,是值得推广的手术。

Objective To analyze the clinical application of laparoscopically assisted vaginal hysterectomy（ LAVH） , so as to make the best choice of operation for patients. Methods 57 cases of patients underwent LAVH （ LAVH group） were analyzed retrospectively,which were compared with 52 cases of patients underwent transvaginal hysterectomy （ TVH） （ TVH group） from january,2009 to febuary,2011. Results The operation time in LAVH group was longer than that in TVH group, taking more operation time to dealing with patients with pelvic adhesion and adnexa; the hospitalization expenses of the LAVH group was higher than that of the TVH group,and the difference was statistically significant （ P〈0. 05） . The bleeding in operation,time to get off the bed,time to anus exhaustion ,the pain incidence and hospitalization time,complications in 2 groups were no significant difference （ P〈0. 05） . Conclusion LAVH and TVH are in common use minimally invasive surgery,both has the advantages of mild pain ,guick recovery and short hospitalization. LAVH is suit for patients with severe pelvic adhesions and the need to examine pelvic,select surgical patients according to disease types and conditions ,and increase durgical safety. LAVH has the merits of both laparotomy and vaginal operation,which expands TVH indications and deserves further popularization.