腹腔镜与开腹巨大子宫切除术的临床比较

Clinical Comparison of Laparoscopic and Open Hysterectomy

目的对比分析巨大子宫患者采用腹腔镜全子宫切除术以及开腹手术治疗的临床效果。方法方便选取2017年1月—2018年6月在该院就诊的40例巨大子宫肌瘤患者,按照不同手术治疗方式随机分为实验组(20例,采用腹腔镜子宫切除术治疗)和对照组(20例,采用传统开腹手术治疗),对比两组患者术中出血量、手术时间、术后排气时间、住院时间以及术后并发症发生率等情况。结果实验组患者术中出血量、手术时间、术后排气时间、住院时间分别为(80.3±8.6)mL、(121.2±9.8)min、(1.5±0.4)d、(6.4±1.4)d与对照组比较差异有统计学意义(t=27.802、4.833、20.142、21.812,P<0.05);实验组患者术后出现切口愈合不良、阴道残端出血等并发症发生率(5.0%)明显低于对照组15.0%,差异有统计学意义(χ2=12.325,P<0.05)。结论巨大子宫患者采用腹腔镜下全子宫切除术治疗的效果更优于传统开腹手术,不仅可有效降低患者术后并发症发生率,也可缩短患者住院时间,可在临床上广泛推广应用。

Objective To compare the clinical effects of laparoscopic hysterectomy and open surgery in patients with giant uterus.Methods 40 patients with giant uterine fibroids who were treated in the hospital from January 2017 to June 2018 were conveniently selected and randomly divided into experimental group (20 cases,treated with laparoscopic hysterectomy) and control group (20 cases,using traditional laparoscopic surgery) according to different surgical treatment methods.The intraoperative blood loss,operation time,postoperative exhaust time,hospitalization time and postoperative complication rate were compared between the two groups.Results In the experimental group,the intraoperative blood loss,operation time,postoperative exhaust time and hospitalization time were (80.3±8.6)mL,(121.2±9.8) min,(1.5±0.4) d,(6.4±1.4) d and the control group was significant (t=27.802,4.833,20.142,21.812,P<0.05).The incidence of complications such as poor wound healing and vaginal stump bleeding in the experimental group was significantly lower than that of the control group (5.0% vs 15%)(χ^2=12.325,P<0.05).Conclusion The effect of laparoscopic hysterectomy in patients with giant uterus is better than traditional laparotomy.It can not only reduce the incidence of postoperative complications,but also shorten the length of hospital stay.It can be widely used in clinical practice.