腹腔镜下子宫切除术四种不同术式效果评价-第三军医大学学报.doc

腹腔镜下子宫切除术4种不同术式效果评价 黄 静 ( 重庆市巴南区人民医院妇科 重庆401320) 摘要：目的:评价我院腹腔镜下子宫次全切除术(LSH)、腹腔镜下筋膜内子宫切除术(CISH)、腹腔镜下全子宫切除术(TLH)和腹腔镜辅助阴式子宫切除术(LAVH)4种手术的临床效果。方法: 对我院2006年3月至2008年3月共120例不同术式腹腔镜子宫切除术的手术时间、出血量、并发症及术后恢复情况等进行回顾研究。结果: 116例手术顺利完成，1例因盆腔粘连严重中转开腹，1例因术中出血中转开腹，2例CISH术中出血不止转LAVH，腹腔镜手术成功率为96.7 %。LSH组手术时间为(98士18.56) min，出血量为(86.12士19.34)ml,CISH组的手术时间为(115士20.15)min，出血量为(118士23.12)ml, TLH组手术时间为(150.3士23.21)min，出血量为(165.6士30.65)ml, LAVH组手术时间为(162士31.24)min，出血量为(150士33.01)ml, 4组术后三天平均体温均未超过38℃，术后第2天肠道能基本恢复。结论: 4 种术式均为腹腔镜下子宫切除的有效术式，各有利弊，应根据患者的具体情况选择适宜术式。 关键词: 腹腔镜检查,;子宫切除术,回顾性研究 Evaluation of the effect of four hysterectomies by abdominoscope HuangJing，（Department of Gynecology,the Banan District Peoples Hospital in ChongQing City,401320，China） Abstract: Objective: To evaluate the clinical effect of four hysterectomies CISH, LSH, TLH and LAVH in our hospital. Methods: Did retrospective study of operation time,bleeding volume complication and recovery conditions after different hysterectumy by abdominoscope on 120 patients from March 2006 to March 2008 in our hospital. Results:116 cases were successful. 2 cases performed abdome operation, one because of severe adherence in pelvic cavity, and another because of bleeding. 2 cases of CISH changed to LAVH because bleed in was out of control. The success rate of abdominoscope was 96.7%. The operation time was(98士18.56)min, (115士20.15)min, (150.3士23.21)min and (162士31.24)min in LSH,CISH, TLH，LAVH and group respectively.The bleeding volume was (86.12士19.34)m1, (118士23.12) m1, (165.6士30.65)ml and (150士33.01)m1 in LSH, CISH, TLH and LAVH group respectively. The third day after operation, the average temperature didn t exceed 38℃ four groups.The function of intestine recovered on the second after hysterectomy.Conclusion:Four hysterectomies are also effective.Each has advantages and dis advantages. So we should choose suitable hysterectomy according to patients specific conditions. Key Words : abdommoscope, hysterectomy, retrospective study