腹腔镜辅助阴式子宫切除术临床探讨.docVIP

腹腔镜辅助阴式子宫切除术临床探讨 　　[摘要] 目的 探讨腹腔镜辅助阴式子宫切除术的临床特点、适应证、并发症及其防治。 方法 回顾分析2008年3月~2010年9月间本院收治的对无生育要求及盆腔器官脱垂而又有全子宫切除术指征的156例患者行LAVH手术的临床资料。 结果 LAVH手术时间一般为60~110 min，平均85 min。术中出血量60~140 mL，22例因肛门排气时间延迟导致腹胀难忍受，经对症处理后恢复良好。术后随访1~1.5年，均无其他并发症出现。结论 腹腔镜辅助阴式子宫切除术手术损伤小、术中出血少、住院时间短、术后疼痛轻，排气时间短，发病率低，恢复快，腹壁瘢痕小，是子宫切除术的理想术式。 　　[关键词] 腹腔镜；辅助阴式子宫切除术；子宫切除；适应证 　　[中图分类号] R713.4+2 [文献标识码] A [文章编号] 1674-4721（2012）04（a）-0075-02 　　 　　Clinical discussion of laparoscopic assisted vaginal hysterectomy 　　ZHOU Bingqin 　　Department of Obstetrics and Gynecology, the Peoples Hospital in Yingshan County, Sichuan Province, Yingshan 637700, China 　　[Abstract] Objective To discuss the clinical characteristics, indications, complications and its prevention of laparoscopic assisted vaginal hysterectomy. Methods The clinical data of 156 cases of patients from March 2008 to September 2010 in our hospital with no fertility requirements and pelvic organ prolapse and hysterectomy indications which done the LAVH operation were retrospectively analysed. Results LAVH operation time were 60-110 minutes in general, with average of 85 minutes. The bleeding intraoperative was 60-140 mL, 22 patients with anal exhaust time delay caused by bloating were treated and recovered well after symptomatic treatment. Postoperative follow-up were 1-1.5 years, no other complications were found. Conclusion Laparoscopic assisted vaginal hysterectomy operation with less injury, less bleeding, shorter hospital stay, less postoperative pain, shorter exhaust time, low incidence, quick recovery, and small abdominal wall scar， it is the ideal method of hysterectomy。 　　[Key words] Laparoscopic; Assisted vaginal hysterectomy; Hysterectomy; Indications 　　 　　近年腹腔镜下子宫切除术已逐渐在多数医院开展，目前主要是行腹腔镜辅助阴式子宫切除术（laparoscopic assisted vaginal hysterectomy，LAVH）、腹腔镜子宫次全切除术（laparo scopicsubtotal hysterectomy，LSH）、腹腔镜全子宫切除术（laparoscopic total hysterectomy，LTH）、腹腔镜筋膜内子宫切除术（class icalintrafascial supracervical hysterectomy，CISH）[1-2]。LAVH是近年发展起来的微创手术，此项手