经腹、经阴道及腹腔镜下子宫切除术的对比分析

Comparative analysis of abdominal hysterectomy,vaginal hysterectomy and laparoscopic hysterectomy

目的比较经腹子宫切除术、腹腔镜下子宫切除术、阴式子宫切除术的临床特点及手术效果。方法回顾性分析因子宫良性病变需行子宫切除的313例患者的临床资料,其中经腹子宫切除术组145例,腹腔镜下子宫切除术组120例,阴式子宫切除术组48例,比较3组患者的手术情况、术后恢复情况及并发症发生情况。结果经腹子宫切除术组的手术时间、住院时间长,术中出血量多,术后镇痛率高,与腹腔镜下子宫切除术组、阴式子宫切除术组比较,差异有统计学意义(P<0.01);经腹子宫切除术组的切口并发症发生率与腹腔镜下子宫切除术组、阴式子宫切除术组比较,差异有统计学意义(P<0.05)。结论经腹子宫切除术手术时间长、术中出血量多、住院时间长、术后镇痛率高,存在切口愈合不良的并发症,与腹腔镜下子宫切除术、阴式子宫切除术比较各有优缺点,临床应根据具体情况选择适当的术式,以达到最佳的治疗效果。

Objective To compare the clinical characteristics and operation results of abdominal hysterectomy,laparo- scopic hysterectomy,vaginal hysterectomy.Methods The clinical data of 313 cases of patients was retrospectively ana- lyzed,145 cases were treated with the abdominal hysterectomy,120 cased were treated with laparoscopic hysterectomy, 48 cases were operated with vaginal hysterectomy.The operation condition,postoperative recovery and complications was observed.Results The operation time,blood loss,average hospital stays and analgesics utilization rates of abdominal- hys- terectomy group compared with that of laparoscopic hysterectomy group and vaginal hysterectomy group,the difference was significant （P〈0.01）.Postoperative incision complications of abdominal hysterectomy group compared with that of laparoscopic hysterectomy group and vaginal hysterectomy group,the difference was significant （P〈0.05）.Conclusion The operation of abdominal hysterectomy takes longer time and more blood loss than that for laparoscopic hysterectomy and vaginal hysterectomy,except it has the same faults of others.It is reasonable to choose the pattern of hysterectomy according to the practical conditions of patients.