腹腔镜子宫切除术与开腹子宫切除术的比较和分析

Comparison Study of Laparoscopic Hysterectomy and Abdominal Hysterectomy in Clinical Practice

目的:比较腹腔镜下子宫切除与开腹方式进行子宫切除的优缺点。方法:选取2010年3月-2013年12月间入院行子宫切除术的患者36例,根据其术式不同分为实验组(16例)和对照组(20例),其中实验组采用的是腹腔镜辅助下阴式全子宫切除术(LAVH),对照组采用的是开腹全子宫切除术(TAH)。结果:两组在年龄、肌瘤直径等方面无显著性差异(P>0.05);对两者在术中出血量、术后抗菌素使用日、术后肠功能恢复、术后住院日、住院费用及术后并发症等进行比较分析,腹腔镜手术组显著减少(P<0.05或0.01)。结论:腹腔镜下子宫切除术较开腹手术具有创伤小、恢复快,住院时间短,术中、术后并发症少等优点,但对器械要求较高,术者应具备丰富的腹腔镜手术经验及技巧,尚不能完全取代开腹手术,合理选择术式是手术成功的关键。

Objective :To Compare advantages and shortages of laparoscopic hysterectomy and abdominal hysterecto-my .Methods :16 patients were received laparoscopic hysterectomy and 20 patients were received abdominal hysterecto-my .The operating time ,decrease of hemoglobin postoperative mortality ,length of hospital stay after operation ,hospi-talization expenses an so on were retrospectively compared .Results:There was no significant difference in age and diam-eter of muscular tumor between two groups (P> 0 .05) .Laparoscopic subtotal hysterectomy is obviously superior to abdominal hysterectomy for its decrease rate of hemoglobin after the operation and a less incidence of complications and less hospitalization time an so on ( P< 0 .05 ) .Conclusion:Laparoscopic hysterectomy has advantages over abdominal hysterectomy for its small wound .Rapid recovery ,less hospitalization time and less complications during and after oper-ation but it can not be substituted for abdominal subtotal hysterectomy ,because it needs higher professional skills of the operators and higher level of appliance choosing a reasonable operation type is the key to a successful operation .