腹腔镜和腹式全子宫切除术在治疗子宫腺肌病的比较

目的子宫腺肌病患者行腹腔镜下全子宫切除术与腹式全子宫切除术的临床效果比较。方法将妇科因子宫腺肌病行腹腔镜全子宫切除术的患者60例设为腹腔镜组，行腹式全子宫切除术的患者31例设为开腹组，比较两组手术时间、术中出血量、术后镇痛用药率、肛门排气时间、术后发热（24-48h体温2次〉38℃）、术后住院天数、术后伤口愈合不良率等指标。结果腹腔镜纽与开腹组相比较，前者手术时间短，术中出血量少，肛门排气时间短，术后住院时间短，差异均有统计学意义（p〈0．05）；术后镇痛药使用率（58．33％），术后并发症发生率（21．67％）和伤口愈合不良率（1．67％）更低（P均〈0．05）。结论腹腔镜用于子宫腺肌病患者全子宫切除术中，能缩短手术时间，减少出血量，由利于术后恢复。

Objective To compare the comparison of clinical effects of laparoscopic total hysterectomy and abdominal total hysterectomy in patients with adenomyosis. Methods Laparoscopic total hysterectomy in 60 cases and abdominal total hysterectomy in 31 cases, the operation time, blood loss, postoperative analgesic used rate, anal exhaust time, postoperative morbidity rate, postoperative hospital stay and postoperative wound poor healing rate were compared between the two groups. Results Operation time was shorter, less bleeding, anal exhaust time was shorter, postoperative hospital stay was shorter, the rate of wound poor healing was lower in the laparoscopic total hysterectomy group than that in the abdominal total hysterectomy group. Conclusion Laparoscopic total hysterectomy has obvious advantage in patients with adenomyosis. It is worth popularizing and applying.