开腹全子宫切除术与腹腔镜辅助阴式子宫切除术的临床治疗效果比较探讨

Study on Comparison of Clinical Treatment Effect of Total Abdominal hysterectomy and Laparoscopically Assisted Vaginal Hysterectomy

目的探讨腹腔镜辅助阴式全子宫切除术和开腹全子宫切除术的临床疗效。方法方便选取2013年1月—2015年10月该院妇科收治的120例需行全子宫切术的子宫疾病患者作为研究对象,并将其随机分为开腹组和腹腔组,各60例,开腹组采用传统的开腹后进行全子宫切治疗,腹腔组采用腹腔镜辅助阴式全子宫切除治疗,比较两组患者的临床治疗效果。结果腹腔组术后镇痛药物使用率(0/23.33%)、住院费用(6 254.52±532.46/5 823.35±487.70)、抗生素使用时间(2.86±2.45/4.71±2.79)、术后肛门排气时间(15.12±2.45/27.86±3.97)、自主排尿时间(17.10±3.76/26.51±5.92)、术后出血量(101.34±18.69/169.24±26.53)、手术时间(78.21±7.30/93.23±11.12)及住院时间(4.32±1.46/6.31±1.57),均明显低于开腹组,住院费用高于开腹组,比较差异有统计学意义(P<0.05);术后切口感染率与术后发热率对比,腹腔组明显低于开腹组,比较差异有统计学意义(P<0.05)。结论腹腔镜辅助阴式全子宫切除术较开腹全子宫切除术有明显优势,具有手术时间短、出血量少、恢复快等优点。

Objective To discuss the clinical curative effect of total abdominal hysterectomy and laparoscopically assisted vaginal hysterectomy. Methods 120 cases of patients with diseases of uterus needing total hysterectomy admitted and treated in the department of gynaecology of our hospital from January 2013 to October 2015 were selected as the research objects and randomly divided into two groups with 60 cases in each, the laparotomy group were treated with total hysterectomy after traditional laparotomy, the laparoscopic group were treated with laparoscopic-assisted vaginal hysterectomy, and the clinical treatment effects were compared between the two groups. Results The usage rate of postoperative analgesic drugs,hospitalization cost, antibiotics consumption, postoperative anus exhaust time, automatic urination time, postoperative blood loss, operative time and length of stay in the laparoscopic group were obviously lower than those in the laparotomy group, [（0% vs 23.33%）,（6254.52±532.46 vs 5823.35±487.70）,（2.86±2.45 vs 4.71±2.79）,（15.12±2.45 vs 27.86±3.97）,（17.10±3.76 vs 26.51±5.92）,（101.34±18.69 vs 169.24±26.53）,（78.21±7.30 vs 93.23±11.12）,（4.32±1.46 vs 6.31±1.57） ], and the hospitalization cost in the laparoscopic group was higher than that in the laparotomy group, and the difference had statistical significance by comparison, P〈 0.05, the postoperative incision infection rate and postoperative fever rate in the laparoscopic group were obviously lower than those in the laparotomy group, and the differences had statistical significance by comparison P0.05.Conclusion Laparoscopic-assisted vaginal hysterectomy has an obvious advantage compared with the total abdominal hysterectomy, and it has the advantages of short operative time, less blood loss and rapid recovery.