腹腔镜阴式全子宫切除术临床应用分析.docVIP

腹腔镜阴式全子宫切除术临床应用分析 　　【摘要】目的 观察和比较腹腔镜阴式全子宫切除术与传统开腹手术的临床效果，探讨最佳手术方式。方法 选择我院收住入院的拟行全子宫切除术的30例患者，分为观察组（15例）和对照组（15例）。观察组患者选择腹腔镜下阴式子宫全切除术，对照组患者选择开腹手术。观察两组患者的临床效果。结果 观察组患者的手术时间、术中出血量、平均住院时间均明显小于对照组；术后离床运动时间、术后肠道功能恢复时间明显早于对照组；术后体温峰值明显低于对照组，使用镇痛药物的机率明显少于对照组，差异均有统计学意义（P0.05）。结论 腹腔镜下阴式全子宫切除手术疗效满意，值得在临床推广应用。 　　【关键词】腹腔镜；阴式全子宫切除术；开腹全子宫切除术 　　【中图分类号】R713.4 【文献标识码】A 【文章编号】ISSN.2095-6681.2017.32..02 　　【Abstract】Objective To observe and compare the clinical effect of laparoscopic vaginal hysterectomy and traditional open surgery，and to explore the best way of operation.Methods Selection in our hospital 30 cases underwent hysterectomy patients， were divided into observation group and control group two groups， 15 cases in each group.The observation group received laparoscopic vaginal hysterectomy， while the control group underwent traditional open surgery.The clinical effects of the two groups were observed.Results The operation time， the amount of bleeding in patients， the average hospitalization time were significantly less than the control group； the observation group of patients with postoperative ambulation time， postoperative anal exhaust time was earlier than the control group， the highest body temperature after operation was significantly lower than the control group， the analgesic drug utilization rate was significantly lower than the control group， the differences were statistically significant （P0.05）.Conclusion Laparoscopic vaginal hysterectomy has satisfactory curative effect， and is worthy of clinical application. 　　【Key word】Laparoscopy； Vaginal hysterectomy； Open total hysterectomy 　　?t疗微创技术的开展，腹腔镜等设备的改进，腹腔镜辅助下阴式子宫全切除术以其创伤小、全程相对舒适、术后并发症较少的特点，成为最近妇科手术治疗的主流术式[1]。我院妇产科采用腹腔镜下阴式全子宫切除术进行治疗，并与开腹手术进行对比，观察两种不同手术方法下的临床效果。 　　1 资料与方法 　　1.1 一般资料 　　选取我院收住入院的拟行全子宫切除术的30例患者，年龄40～55岁，平均47.5岁；子宫大小如孕8～16周。所有患者术前已经施行子宫内膜分段诊刮术和（或）宫颈TCT检查，送病理检查均排除恶性肿瘤，患者及家属均表示同意此手术方式并签署书面同意书。根据患者自选不同术式分为观察组和对照组，每组15例。 两组在年龄，体重指数，子宫大小等临床资料方面相比较，差异无统计学意义（P0.05）。 　　1.2 手术方法 　　两组患者术前常规清洁灌肠，均采用气管插管下全身麻