腹腔镜全子宫切除术和腹腔镜辅助下阴式子宫切除术用于全子宫切除手术中的应用价值研究

Comparison of application value of LTH and LAVH in hysterectomy

目的探讨腹腔镜全子宫切除术(LTH)和腹腔镜辅助下阴式子宫切除术(LAVH)用于全子宫切除的效果。方法选取2015年2月-2017年2月在该院行子宫全切除的患者182例。其中,行LTH患者97例,行LAVH患者85例,观察两组手术时间、术中出血量、疤痕长度和术后肛门排气时间等,同时检测两组手术前后C反应蛋白(CRP)、白细胞介素-2(IL-2)和白细胞介素-6(IL-6)。结果 LTH组术中出血量和疤痕长度分别为(104.33±40.20)ml和(2.03±0.84)cm,明显低于LAVH组,差异有统计学意义(P<0.05);LTH组和LAVH组术后肛门排气时间、住院天数、术后镇痛比例及住院费用差异比较无统计学意义(P>0.05);LTH组术后CRP和IL-6分别为(26.43±6.11)mg/L和(40.04±11.03)ng/ml,明显低于LAVH组,差异有统计学意义(P<0.05),而IL-2为(44.20±12.29)ng/ml,明显高于LAVH组,差异有统计学意义(P<0.05);LTH组术后并发症发生率为6.19%,明显低于LAVH组,差异有统计学意义(P<0.05)。结论 LTH用于子宫切除是安全可靠的方法,具有并发症少、对机体免疫功能影响小等优点,值得临床推广使用。

Objective To investigate the effect of total laparoscopic hysterectomy(LTH)and laparoscopic assisted vaginal hysterectomy(LAVH)for hysterectomy.Methods From February2015to February2017,182patients with total hysterectomy were enrolled,among them,LTH was performed in97patients,and LAVH was performed in85patients,the operation time,intraoperative blood loss,the length of scar,postoperative anal exhaust time and so on were observed in the two groups,C reactive protein(CRP),interleukin-2(IL-2)and IL-6were detected before and after operation in two groups.Results In group LTH,the amount of bleeding and the length of scar were(104.33±40.20)ml and(2.03±0.84)cm respectively,which were significantly lower than those in group LAVH(P<0.05);There was no significant difference between LTH group and LAVH group in postoperative anal exhaust time,hospital stay,postoperative analgesia and hospitalization costs(P>0.05);The CRP and IL-6in the LTH group postoperative were(26.43±6.11)mg/L and(40.04±11.03)ng/ml,significantly lower than those in LAVH group(P<0.05),while IL-2was(44.20±12.29)ng/ml,was significantly higher than that of the control group(P<0.05);The incidence of postoperative complications in LTH group was6.19%,which was significantly lower than that of LAVH group(P<0.05).Conclusion LTH is a safe and reliable method for hysterectomy,has the advantages of less complications,less influence on immune function and so on,is worthy of clinical application.