非脱垂大子宫腹腔镜下子宫切除与阴式子宫切除术的临床比较.docVIP

PAGE  PAGE 3 非脱垂大子宫腹腔镜与阴式子宫切除术的比较 韦德华1,2 史惠蓉1 朱卫华2 1郑州大学第一附属医院妇科 郑州450052,；2濮阳市人民医院妇科，河南濮阳，457000 通讯作者：史惠蓉 博士 教授 博士生导师，郑州大学第一附属医院妇科，E-mail hrshi2011@163.com 摘要 目的 探讨非脱垂大子宫经腹腔镜下子宫切除术（TLH）与经阴道子宫切除术（TVH）的临床效果。方法 回顾性分析比较140例非脱垂大子宫（子宫体积如孕12-14周）经腹腔镜下子宫切除术（TLH）与经阴道子宫切除术（TVH）的临床资料，包括手术时间，术中出血量，术中、术后并发症、术后肛门排气时间、术后病率、下床活动时间、住院费用和术后住院日。结果 TVH 组1例术中中转开腹，TLH组无中转开腹者，TLH 组较TVH组手术时间长（p 0.01）, 术中出血量，术后病率，术后肛门排气时间、下床活动时间、术后住院日（p 0.01）；TLH组较TVH 组住院费用高（p 0.01）。结论 大子宫经腹腔镜下子宫切除术虽然较经阴道切除住院费用高，但对病人损伤小、术后恢复快，术后住院时间短。 关键词：腹腔镜下子宫全切除术；阴式子宫切除术；大子宫 中图分类号：R713.42 文献标示码：B 文章编号： Analysis of two operations for large uterus Wei Dehua1,2 Shi Huirong1 Zhu Weihua2 1 The Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,2 the People’s Hospital of Puyang city, Puyang 457000 Abstract Objective To compare the clinical value of total laparoscopic hysterectomy(TLH) and Transvaginal hysterectomy(TVH) for large uterus.Method Intraoperative and postoperative characteristics of 70 patients undergoing TVH and 70 patients undergoing TLH were analyzed retrospectively,including operative time,intraoperative blood loss,complications,the first time to getting out of bed, recovery of bowel movement,postoperative morbidity, cost for hospital stay and hospital days.Result TLH was superior to TVH in the blood loss in operation, mean time of surgery, the first time to getting out of bed,recovery of bowel movement,mean postoperative stay and morbidity（p 0.05）.Cost for hospital stay was significantly higher for TLH than TVH（p0.05）.Conclusion TLH is superior to TVH for large uterus. Key Words Transvaginal hysterectomy；vaginal hysterectomy; large uterus 随着微创技术的不断发展，阴式子宫切除术（Transvaginal hysterectomy，TVH）和腹腔镜下子宫切除术（total laparoscopic hysterectomy，TLH）日趋广泛，为比较其优缺点，我们对140例阴式子宫切除术和腹腔镜下子宫切除术临床资料进行回顾性分析，报道如下。 1资料及方法 1.1 研究对象：2009年4月-2012年12月间濮阳市人民医院收治的因各种子宫良性病变而行子宫切除术140例，无心、肝、肾、肺等疾病，无手术史，其中TVH70例，TLH70例，均为已婚已育妇女，并符合下列条件： =