三种途径子宫切除术的临床观察

Clinical Observation of Hysterectomy Through Three Kinds of Approach

【目的】探讨开腹全子宫切除术 (TAH)、腹腔镜辅助阴式子宫全切术 (LAVH)和阴式子宫切除术(TVH)三种手术方法临床疗效的优缺点。【方法】对 10 4例子宫切除术的患者分别采用TAH ,LAVH ,TVH三种不同手术方法 ,然后统计其手术时间、术中出血量、术后排气时间、下床活动时间和术后住院天数。【结果】三种手术方法中手术时间、术后排气时间、下床活动时间和术后住院天数差异具有显著性 (P <0 .0 1)其中LAVH ,TVH为佳 ,而三种手术方法中术中出血量差异无显著性 (P >0 .0 5 )。【结论】LAVH和TVH安全性好、创伤小、病人痛苦少 ,术后恢复快 ,但应视病人具体情况做出选择。

Objectives]To evaluate the advantages and disadvantages of therapeutic efficacy during application of three kinds of operative approaches ?trans-abdominal hysterectomy (TAH), laparoscopic assistant vaginal hysterectomy (LAVH) and trans-vaginal hysterectomy (TVH).Hysterectomies in one hundred and four patients were performed by three different approaches (TAH, LAVH and TVH), then their duration of operation, the hemorrhage quantity in operation, the time of air exhaust after operation, the time of ambulation and number of days in hospitalization were analyzed statistically.Significant differences existed in duration of operation, the time of air exhaust after operation, the time of ambulation and number of days in hospitalization among three approaches of hysterectomy (P<0.01), better therapeutic efficacy was obtained in LAVH and TVH. There were no obvious differences in hemorrhage quantity of operation among three approaches (P>0.05).[Conclusion]LAVH and TVH show several advantages , including good safety, less trauma, less pain and quick recovery ; but the choice of operation should be made according to the actual condition of patients.