腹腔镜辅助阴式全子宫切除术在巨大子宫肌瘤治疗中的应用价值

Application Value of Laparoscopically Assisted Vaginal Hysterectomy in the Treatment of Huge Leiomyoma Uterus

目的:研究腹腔镜辅助阴式全子宫切除术(Laparoscopic assisted vaginal hysterectomy,LAVH)在巨大子宫肌瘤(Huge leiomyoma uterus,HLU)治疗中的应用价值。方法:从2012年9月到2013年9月,选择在我院接受手术治疗的HLU患者130例作为研究对象。根据手术方案进行分组,其中LAVH组65例,TAH组65例,对比两组手术情况,术后并发症情况以及两组患者疼痛情况。结果:LAVH组的肛门排气时长、下床活动时长、住院时长均显著少于TAH组,但手术时长大于TAH组,差异均有统计学意义(均P<0.05)。两组在术中出血量方面对比,差异无统计学意义(P>0.05)。LAVH组的术后并发症与TAH组相比,差异无统计学意义(P>0.05)。LAVH组的VAS评分及VDS评分均显著低于TAH组,差异均有统计学意义(均P<0.05)。结论:LAVH术式在HLU中具有较大的应用价值,临床上应重视其适应证,优先选择此类术式,效果显著,值得临床关注。

Objective： To study the application value of laparoscopically assisted vaginal hysterectomy in the treatment of huge leiomyoma uterus. Methods： 130 HLU patients tmdergoing surgery from September 2012 to September 2013 in our hospital were chosen for the study and were devided into the LAVH group, with 65 patients, and the TAH group with 65 cases, according to the surgery programs. Surgery, postoperative complications and patients＇pain conditions were compared between the two groups. Results： LAVH group＇s time of anal exhaust, ambulation and hospitalization were significantly shorter than that of TAH group respectively, but surgery time in TAH surgery group was longer, and the differences were statistically significant （P 〈0.05）. The blood loss in the two groups presented no statistically significant difference （P〉 0.05）. Difference in postoperative complications was not statistically significant when compared between the two groups （P〉 0.05）. LAVH group＇s VAS score and VDS scores were significantly lower than those of TAH group, and the differences were statistically significant （P 〈0.05）. Conclusion： LAVH procedure has great value in treating HLU, so we should attach importance to the clinical indications. The effect of such style of surgery is significant and it is worthy of attention.