非脱垂大子宫的腹腔镜与阴式子宫切除的比较

Analysis of two operations for large uterus

目的探讨非脱垂大子宫经腹腔镜下子宫切除术(TLH)与经阴道子宫切除术(TVH)的疗效。方法回顾性比较140例非脱垂大子宫(子宫体积如孕12-14周)经腹腔镜下子宫切除术(TLH)与经阴道子宫切除术(TVH)两种手术方式的手术时间,估计出血量,并发症、术后病率、胃肠功能恢复时间等。结果 TVH组1例术中中转开腹,TLH组无中转开腹者,TLH组较TVH组手术时间长(P<0.01),术中出血量,术后病率,胃肠功能恢复时间、最早自主下床活动时间、术后住院日(P<0.01);TLH组较TVH组住院费用高(P<0.01)。结论大子宫经腹腔镜下子宫切除术虽然较经阴道切除住院费用高,但对病人损伤小、术后恢复快,术后住院时间短。

Objective To compare the clinical value of total laparoscopic hysterectomy（TLH） and Transvaginal hysterectomy（TVH） for large uterus. Methods Intraoperative and postoperative characteristics of 70 patients undergoing TVH and 70 patients undergoing TLH were analyzed retrospectively,including operative time,intraoperative blood loss,complications,the first time to getting out of bed,recovery of bowel movement,postoperative morbidity,cost for hospital stay and hospital days. Results TLH was superior to TVH in the blood loss in operation,mean time of surgery,the first time to getting out of bed,recovery of bowel movement,mean postoperative stay and morbidity（P〈0. 05）. Cost for hospital stay was significantly higher for TLH than TVH（P 〉0. 05）. Conclusion TLH is superior to TVH for large uterus.