腹腔镜全子宫切除术和腹腔镜辅助阴式全子宫切除术临床疗效比较

Comparison of clinical efficacy of total laparoscopic hysterectomy and laparoscopic-assisted vaginal hysterectomy

目的比较腹腔镜全子宫切除术(total laparoscopic hysterectomy,TLH)和腹腔镜辅助阴式全子宫切除术(laparoscopic-assisted vaginal hysterectomy,LAVH)的临床疗效。方法选取符合全子宫切除手术指征的患者100例。根据手术方式的不同将患者分为TLH组和LAVH组,各50例。观察比较两组患者术中出血量、手术时间、住院时间、肛门排气时间及术后并发症等指标。结果与LAVH组患者相比,TLH组患者术中出血量、手术时间均减少,差异具有统计学意义(P<0.05);但TLH组患者的术后排气时间、住院时间以及并发症发生率与LAVH组比较,差异无统计学意义(P>0.05)。结论两种手术方式均有效、微创,且TLH具有术中视野清晰、出血少、手术时间短的优点。但应根据患者病情全面评估选择最佳手术方案,达到缓解或治愈的目的。

Objective To compare the clinical efficacy of total laparoscopic hysterectomy（TLH） and laparoscopic-assisted vaginal hysterectomy（LAVH）. Methods Totally 100 cases in the line with hysterectomy surgical indications were divided into TLH group and LAVH group depending on the surgical approach, 50 cases in each group. Indicators were compared between the two groups, such as blood loss, operation time,length of stay, flatus time and postoperative compli- cations. Results Compared with patients in LAVH group, both blood loss and operation time were reduced in TLH group, and the difference was statistically significant （ P 〈 0. 05 ） ; But the length of stay, flatus time and postoperative complications in the two group were approximate,and the difference was not statistically significant（P 〈 0. 05 ）. Conclusion Both surgical approach are effective, minimally invasive, and the surgical approach of TLH has more advantage, such as clearer vision, less bleeding and shorter operative time. But we should choose the best surgical plan based on the patients＂ condition and comprehensive assessment, to alleviate or cure disease.