经腹、阴式、腹腔镜辅助下阴式子宫切除术的临床应用分析

Clinical Application of Trans-abdominal,Vaginal and Laparoscopic Assisted Vaginal Hysterectomy

目的:分析腹腔镜下全子宫切除术、开腹手术、完全阴式手术之优劣,分析适应证、并发症特点,总结术式选择、应用、管理经验。方法:2014年9月,医院共开展子宫切除术37例,开腹20例,阴式14例,腹腔镜下辅助阴宫3例。结果:不同手术子宫>12孕周、手术史、适应证差异无统计学意义(P>0.05);阴式手术手术时间、术中出血量、术后住院时间低于经腹手术,差异均有统计学意义(P<0.05);经腹手术、阴式手术术后排气时间差异无统计学意义(P>0.05);经腹手术并发症发生率高于阴式手术,差异均有统计学意义(P<0.05)。结论:经腹、阴式、腹腔镜辅助下阴式子宫切除术中,阴式手术创伤小、出血少、住院短,并发症发生率低,腹腔镜辅助下阴式子宫切除术例数少,需积极总结经验。

Objective：To analyze the advantages and disadvantages of laparoscopic hysterectomy,laparotomy,complete vaginal surgery,indications and complications,and summarize the selection,application and management experience.Methods：In September 2014,the hospital carried out a total of 37 cases of hysterectomy,laparotomy in 20 cases,14 cases of vaginal,laparoscopic assisted uterine artery in 3cases.Results：When gestational week more than 12 weeks,there was no significant difference in operation history and indication between the two groups（P〉0.05）.Vaginal surgery time,intraoperative blood loss,postoperative hospital stay of transvaginal surgery were statistically significant lower than trans-abdominal operation,（P〈0.05）.There was no significant difference in the exhaust time between transvaginal surgery and transabdominal operation（P〉0.05）.The incidence of complications of abdominal surgery is higher than vaginal surgery,with statistical significant difference（P〈0.05）.Conclusion：Among transvaginal,vaginal,laparoscopic assisted vaginal hysterectomy,vaginal surgery has the advantage of less trauma,less bleeding,short hospitalization,low incidence of complications.There are few cases of laparoscopic assisted vaginal hysterectomy surgery,which needs to accumulate experience.