腹腔镜子宫切除术85例临床分析.docVIP

腹腔镜子宫切除术例临床分析 （乐山市人民医院，四川　乐山，614000） 【摘要】 目的：探讨腹腔镜子宫切除术的临床价值及减少并发症的措施。方法：在腹腔镜下对例患者施行子宫切除术，与例剖腹术式进行比较，就术式选择、手术优越性、适应症、并发症进行对比分析。结果：腹腔镜辅助的经阴道子宫切除术式（LAVH）受子宫大小及膀胱反折腹膜粘连的影响，适用于子宫小于12周尤其是临床高度怀疑子宫颈或内膜有恶变倾向者。腹腔镜下子宫次切术（LSH）可保持宫颈及盆底正常解剖结构的完整性，而且手术受子宫大小及其与周围粘连的限制少。腹腔镜下子宫切除具有术中出血量少及手术时间不延长、术后疼痛轻、术后病率低、手术并发症少、住院时间短、术后恢复快等优点。结论：腹腔镜子宫切除手术具有微创、效优的特点，值得推广应用，提高操作技能是减少并发症的关键。 【关键词】 腹腔镜；子宫切除术 Clinical analysis of cases of laparoscopic hysterectomy Luo Xiao (The People’s hospital of Leshan ， Leshan 614000 ，Sichuan) 【Abstract】 Objective: To investigate the clinical value of Laparoscopic hysterectomy and to decrease the complication of laparoscopic hysterectomy .Methods: patients that were treated with laparoscopy hysterectomy and were compaired with 100patients that were treated with transabdomynal hysterectomy, Thy different forms of technique were performed for the different surgical indication of these cases, which were analysed for the condition of intraoperation and postoperation, the superiority, indication and complication. Results: The laparoscopy assisted vaginal hysterectomy (LAVH) were limited by the uterine size and the adhesion of peritoneal fold, LAVH was suitable for patients with the uterus less than pregnant 12 weeks size especially when suspicion of malignancy of the cervix uteri or endometrium.Laparoscopic supracervical hysterecto- my(LSH) might preserve the intact of normal pelvic anatomy and cervix uteri, also no limitation of the uterine size. The laparoscopic hysterectomy would provide an advantage of less intraoperative bleeding with no longer operation time, less morbidity,shorter hospitalization and rapid recovery. Conclusions: Laparoscopic surgery is worthy of being advocated owing to its benefit, Raising operative ability is the key of reducing complication. 【key words】 Laparoscopy；Hysterectomy 近年来，腹腔镜子宫切除术作为一种微创手术越来越多地在临床应用。我院自2002年11月开展腹腔镜子宫切除术，主要术式为腹腔镜辅助的经阴道子宫切除术（LAVH）[1]和腹腔镜下子宫次切术（LSH）[2]。为研究腹腔镜切除子宫的可行性、安全性，现回顾对比分析上述两种术式下例子宫切除与剖腹子宫全切除术（TAH）例的多项指标，报道如下：