杯状举宫器在腹腔镜全子宫切除术中应用.docVIP

杯状举宫器在腹腔镜全子宫切除术中应用 　　【摘要】 目的探讨用杯状举宫器行腹腔镜全子宫切除(TLH)与用举宫棒行腹腔镜全子宫切除两种术式的临床应用效果。方法 2006年4月至2009年2月有手术指征的子宫肌瘤,子宫腺肌症,功能性子宫出血,CIN3共100例,运用杯状举宫器行TLH 70例,用举宫棒行TLH 30例,两组均采用双极电凝完成子宫切除,比较两种术式的临床效果。结果 TLH2组比TLH1组手术时间短,术中出血少,肛门排气快时间,住院时间短,差异有统计学意义(P0.05),TLH1组并发症少。结论 使用杯状举宫器行腹腔镜下全子宫切除术,提高了手术的安全性且操作简捷,解决分离膀胱输尿管困难、切开阴道穹窿界限不清技术难题和降低手术费用等问题,有利于腹腔镜子宫切除术的普及推广。 　　【关键词】 腹腔镜;全子宫切除;杯状举宫器 　　 　　Application of cup-type uterine manipulateor in total laparoscopic hysterectomy 　　 　　ZHANG Hua, LI Hong-yan, WU Bai-jiao.Yuexiu District Matermal Hospital, Guangzhou 510030, China 　　 　　【Abstract】 Objective To investigate the clinical application effects of cup-type uterine manipulator and stick-type uterine manipulator in total laparoscopic hysterectomy (TLH).Methods 100 cases with the operative indication of hysteromyoma, Uterine adenomyosis,dysfunctional uterine bleeding, CIN3. Total laparoscopic hysterectomy (TLH) was employed on all the cases, while using cup-type uterine manipulator in 70 cases, the other 30cases using stick-type uterine manipulator. Both of the two groups complete the TLH by using bipolar coagulation. Compare the effects of the two different operative patterns.Results Compare with TLH2 group, TLH1 group took less time, less bleeding volume in operation, earlier anus exhaust, and shorter length of stay. The difference is statistical significance, with P0.05. Besides, TLH1 group has less complication.Conclusion Use of the cup-type uterine manipulator in total laparoscopic hysterectomy makes the procedure easier and safer.It solves many problems, including the difficulty in separating the vesicoureter, the skill in cutting open the vaginal fornix, and the charge of the operation. It is benefit for the THL to be popularized. 　　【Key words】 Laparoscopy; Total hysterectomy; Cup-type uterine manipulator 　　 　　作者单位:510030广州市越秀区妇幼保健院妇产科 　　 　　腹腔镜全子宫切除术是指在腹腔镜下将子宫完全切除,经阴道取出切除的子宫,并在腹腔镜缝合阴道残端。广州市越秀区妇幼保健院妇产科2006年4月至2009年2月,对本院100例有全子宫切除指征的患者用杯状举宫器行腹腔镜全子宫切除或用举宫棒行腹腔镜全子宫切除,比较其临床效果。