腹腔镜下子宫次全切除术286例临床剖析.docVIP

腹腔镜下子宫次全切除术286例临床剖析 　　【摘要】 目的 评价腹腔镜下子宫次全切除术的效果及价值。方法 回顾性分析本院1999年9月至2006年8月286例手术时间、术中出血、术后恢复情况、术后并发症发生率等。结果 278例顺利完成手术，8例因粘连严重而中转开腹，手术成功率达97．20%，手术时间(85．3±26．8)min，术中出血量(42．1±20．1)ml，术后肠功能恢复时间(22．7±5．9)h，术后下床活动时间(26．2±9．6)h，术后住院时间(4．2±1．0)d，无严重并发症。结论 腹腔镜下子宫次全切除术具有安全、术中出血少、恢复快、手术操作简单易于掌握等优势。? 　　【关键词】 腹腔镜；子宫次全切除术?? 　　Clinical analysis of 286 cases of laparoscopic supracervical hysterectomy 　　ZHANG Li, LIU Yue-wang,CHU Shu-hua, et al.Department of Obstetrics and Gynecology, Kunming General Hospital,Kunming,Yunlan650032, China 　　? 　　【Abstract】 Objective To investigate effects and techniques of laparoscopic supracervical hysterectomy(LSH)． MethodsA retrospective analysis was carried out on 286 cases of laparoscopic supracervical hysterectomy in this hospital from September 1999 to August 2006 in respect of operating time, intraoperative blood loss,postoperative recovery, and incidence of complications． ResultsLSH was performed successfully in 278 cases, whereas a conversion to open surgery was required in 8 cases because of serious adhesion． The success rate was 97．20%． The operation time was(85．3±26．8)min, the intraoperative blood loss was(42．1±20．1)ml, the time to postoperative gastrointestinal function recovery was (22．7±5．9)h, the time to postoperative get up was (26．2±9．6)h, postoperative hospital stay was (4．2±1．0)d． No severe complication occurred. Conclusion Laparoscopic supracervical hysterectomy demonstrates excellent safety minimal invasion, less blood loss, and quick recovery to normal activities． The LSH is simple and easy to be mastered．? 　　【Key words】Laparoscopy; Laparoscopic supracervical hysterectomy 　　? 　　 　　腹腔镜子宫次全切除术（laparoscopic supracervical hysterectomy, LSH)具有微创、出血少、恢复快、操作简单、住院时间短等优点，越来越多地受到广大妇科医师及患者的欢迎。本文对成都军区昆明总医院1999年9月至2006年8月286例腹腔镜子宫次全切除术的临床资料进行回顾性分析，现报道如下。? 　　1 资料与方法? 　　1．1 临床资料 1999年9月至2006年8月本院收治有子宫次全切除术指征的子宫良性病变患者286例，年龄32~53岁，平均40．5岁，术前诊断：子宫肌瘤207例、子宫腺肌病或合并子宫内膜异位症57例、子宫腺肌病合并子宫肌瘤22例、功能性子宫出血2例。单发肌瘤23例，余均为多发肌瘤，最大的肌瘤为10．5 cm ×8