腹腔镜子宫切除术两种术式比较.docVIP

腹腔镜子宫切除术两种术式比较[摘要] 目的:探讨腹腔镜下两种子宫切除术式的临床应用价值。方法:对腹腔镜筋膜内子宫切除术(CISH)96例和腹腔镜下辅助阴式子宫切除术(LAVH) 45 例患者的临床资料进行回顾性分析,比较两种术式的手术时间、术中出血量、术后恢复及并发症发生情况。结果:CISH 组手术时间短,术中出血少于LAVH 组,两组间比较,差异有显著性;两组在中转开腹、并发症发生方面差异无显著性;术后两种术式恢复均良好。结论:腹腔镜子宫切除术具有微创、效优的特点,值得临床推广。根据不同的病情选择合适的手术方式是减少并发症、提高手术安全性的关键。 [关键词] 腹腔镜;子宫切除术;比较 [中图分类号] R713.4+2[文献标识码]A[文章编号]1673-7210(2009)07(c)-035-02 Comparison between the two operation methods of laparoscopic hysterectomy ZHANG Yanrong (Department of Obstetrics and Gynecology, People’s Hospital of Anyang City,Anyang455000,China) [Abstract] Objective: To explore the clinical value of two operation methods of laparoscopic hysterectomy. Methods: The clinical data of 96 cases of classic intrafascial semm hysterectomy(CISH group) and 45 cases of laparoscopic assisted vaginal hysterectomy(LAVH group) were analyzed retrospectively. The operation time,intraoperative blood loss, postoperative recovery,and complications were compared between the two groups. Results: The operation time and intraoperative blood loss of CISHgroup were less than those of LAVH group, there was significant difference between the two groups.The convertion to open operation and complications of two groups had no significant difference; two groups all had good postoperative recovery. Conclusion: Laparoscopic hysterectomy has advantages such as minimal invasion and good effect, it is worthy of being spreaded. According to the disease selecting the proper operation is the key to decreasing complications and improving the safety of operation. [Key words] Laparoscopy; Hysterectomy; Comparison 子宫切除术是妇科最常见的手术之一,而腹腔镜子宫切除术以其损伤小、出血少、恢复快等特点,已成为妇科最受关注的代表性术式,目前主要有腹腔镜筋膜内子宫切除术CISH)、腹腔镜辅助阴式子宫切除术(LAVH)、腹腔镜全子宫切除术(LTH)、腹腔镜次全子宫切除术(LSH),其中CISH、LAVH在我院妇产科临床手术中应用较多。我院2004年1月～2005年12月分别用两种方法进行腹腔镜下子宫切除术141例,现报道如下: 1 资料与方法 1.1 一般资料 我院行腹腔镜下子宫切除术141例,其中,CISH96例,LAVH 45例。其中,中转开腹6例。CISH组年龄39～56岁,平均40岁,有盆腔手术史者21例;LAVH组年龄38～71岁,平均48岁,有盆腔手术史者6例。子宫大小:CISH组孕12周28例,孕8～12周48例,孕12周6例,孕8～12周15例,孕12周,并子宫