不同子宫动脉及宫颈残端处理方法在腹腔镜下次全子宫切除术中的比较

The Comparison of Different Methods of Uterine Artery and Cervical Stump in Subtotal Hysterectomy Under Laparoscopy

目的：观察两种不同的子宫动脉及宫颈残端处理方法在腹腔镜下次全子宫切除术中的临床效果。方法收集2011年1月～2013年1月接受腹腔镜下次全子宫切除术的患者122例，其中62例在子宫动脉处理中行子宫动静脉缝扎，宫颈残端予1-0可吸收线缝合；60例用自制线圈套扎子宫峡部阻断子宫动脉血供。对2组手术时间、术中出血量、恢复排气时间、术后住院时间及随访情况进行比较分析。结果2组手术时间、术中出血量、恢复排气时间差异无统计学意义（P＞0.05），术后住院时间及术后并发症差异有统计学意义（P＜0.05）。结论腹腔镜下次全子宫切除术中行双侧子宫动静脉缝扎，宫颈残端予以缝合的方法安全、有效，且患者术后恢复快，住院时间短，术后并发症少，值得推广应用。

Objective To observe the clinical effect of two different methods of uterine artery and cervical stump in subtotal hysterectomy under laparoscopy.Methods We collected 122 cases of patient from Jan., 2011 to Jan., 2013 who accepted the subtotal hysterectomy under laparoscopy. Among them, in 62 cases we used the uterine arteriovenous seam in the dispose of uterine artery, and 1-0 absorbable thread in the end of cervix; in 60 cases we used the homemade coil thread to loop the isthmus uteri to block the blood supply of uterine artery. We compared the operation time, intraoperative blood loss, recovery exhaust time, postoperative hospital stay period and follow-up comparative analysis in two groups.Results The operation time, intraoperative blood loss, recovery exhaust time has no statistical signifi cance （P〉0.05）. The postoperative hospital stay period and follow-up comparative analysis has the statistical signifi cance （P〈0.05）.Conclusion The method of the arteriovenous transfi xion of bilateral uterine and suture the cervix-end in the subtotal hysterectomy under the laparoscopy is safe and effective with rapid postoperative recovery, shorter hospitalization time, less postoperative complications which is worthy of popularization and application.