腹腔镜下全子宫切除术150例临床分析

Total Laparoscopic Hysterectomy:Clinical Analysis of 150 Cases

目的探讨腹腔镜下全子宫切除术的临床应用价值。方法选择因子宫、宫颈疾病行全子宫切除术患者300例,其中行腹腔镜下全子宫切除术患者(腹腔镜组)150例,行经腹筋膜外全子宫切除术患者(经腹组)150例。观察2组手术时间、术中出血量和术后肛门排气时间、下床活动时间、保留尿管时间、术后住院时间及术后并发症的情况。结果与经腹组比较,腹腔镜组手术时间长,术中出血量少,术后肛门排气时间、下床活动时间、保留尿管时间和住院时间均缩短,切口液化发生率低(均P<0.05)。结论腹腔镜下全子宫切除术具有手术创伤小、出血量少、胃肠功能恢复快及住院时间短等优点,是一种较理想的手术方式。

Objective To investigate the clinical value of total laparoscopic hysterectomy. Methods Three hundred patients with uterine and cervical disease were assigned to receive either total laparoscopic hysterectomy（laparoscopic group,n=150）or transabdominal extrafascial hys-terectomy（transabdominal group,n=150）.The operative time,intraoperative blood loss,time to first postoperative flatus,time to ambulation,duration of indwelling urinary catheterization,post-operative hospital stay and postoperative complications were observed in both groups.Results Compared with transabdominal group,total laparoscopic hysterectomy prolonged the operative time,reduced the intraoperative blood loss,shortened the time to first postoperative flatus,time to ambulation,duration of indwelling urinary catheterization and length of postoperative hospital stay,and decreased the incidence of incision liquefaction（P 〈0.05）.Conclusion Total laparoscop-ic hysterectomy is an ideal surgical approach,which is associated with smaller incision,less bleed-ing,faster recovery of gastrointestinal function and shorter hospital stay.