经阴道NOTES子宫加附件切除临床应用分析

Analysis of the Application Effect of Transvaginal NOTES Total Hysterectomy

目的探讨经阴道自然腔道内镜(natural orifice transluminal endoscopic surgery,NOTES)全子宫加附件切除术的临床应用价值。方法选取2018年8月-2019年7月间高州市人民医院行全子宫加附件(或输卵管)切除术的患者60例,根据患者选择按手术方式不同将其分成两组,观察组(30例)行经阴道自然腔道内镜手术,对照组(30例)行传统多孔腹腔镜手术。观察患者手术耗时、术中出血量、术后疼痛评分、术后胃肠功能恢复时间、手术并发症、术后住院时长、住院总费用、手术切口及术后疤痕情况。结果观察组患者手术耗时、术中出血量、术后住院时间、住院总费用、手术并发症与对照组相似,差异无统计学意义(P> 0.05),但术后疼痛评分、术后胃肠功能恢复时间、手术切口及术后疤痕优于对照组,差异有统计学意义(P <0.05)。结论经阴道自然腔道内镜全子宫加附件(或输卵管)切除术对患者创伤更小,术后疼痛更轻,恢复快;体表不留瘢痕,具有减轻疼痛和体表无痕的优势。

Objective To study the value of clinical application for the transvaginal natureal orifice transluminal endoscopic surgery total hysterectomy. Methods 60 patients underwent hysterectomy in Gaozhou people’s hospital from August 2018 to July 2019 were selected and divided into two groups according to the patient’s choice of opreation. The observation group(n =30)underwent transvaginal natureal orifice transluminal endoscopic surgery total hysterectomy. The control group(n=30)underwent traditional total laperoscopic hysterectomy. The patient’s operative time, intraoperative blood loss, postoperative VAS score, mean postoperative recovery of gastrointestinal exhaust, length of stay, total cost, complications, operative incision and scar after the operation were observed. Results There were no significant differences in operative time, intraoperative blood loss, length of stay, average cost and complications between the observation group and the control group(P > 0.05). But the postoperative VAS score, mean postoperative recovery of gastrointestinal exhaust, operative incision and scar after the operation were better in the observation group than those in the control group. The difference was statistically significant(P < 0.05). Conclusion The transvaginal natureal orifice transluminal endoscopic surgery total hysterectomy has less trauma,lower postoperative VAS score and faster recovery to the patients. There is no scar on the abdomen, which has the advantages of relieving pain and beautifying.