非脱垂子宫全切术三种术式临床分析

目的比较非脱垂子宫行开腹子宫切除术（TAH）、阴式子宫切除术（TVH）和腹腔镜辅助子宫全切术（LAVH）三种术式的临床效果。方法回顾性分析行TAH95例、TVH88例及LAVH75例的非脱垂子宫患者的临床资料。对三种手术患者术中、术后情况及手术费用进行比较。结果三种手术方式的手术时间、术中出血量、术后病率、术后排气时间、术后下床活动时间、术后住院天数、平均住院费用比较，差异均有统计学意义（P〈0．05）。结论三种术式各有优劣，LAVH和TVH具有创伤小、术中出血少、术后恢复快、住院天数短等优点，但LAVH费用较高，也不能完全替代开腹手术，应根据患者的具体情况选择合适术式。

Three types of total hysterectomy for unprolapsed uterus

Objective To compare the clinical effects of total abdominal hysterectomy （TAH）, transvaginal hysterectomy （ TVH ） and laparoscopic - assisted vaginal hysterectomy （ LAVH ） for unprolapsed uterus. Methods A retrospective survey was made on 95 patients who had undergone TAH, 88 cases of TVH, 75 cases of LAVH. The effects of operation, recovery and cost of the three groups were compared. Results There were significant differences in the operative time, the blood loss during surgery, postoperative morbidity, anal exhaust time, postoperative ambulation, postoperative hospital stay, average hospital charges among the three groups （ P 〈 0.05 ）. Conclusions Three surgical methods have advantages and disadvantages. LAVH and TVH had the advantages of less trauma, less bleeding, rapid postoperative recovery, shorter hospital stay, etc. However, the cost of LAVH is more expensive, LAVH can not completely replace TAH. We should select the appropriate surgical procedures based on the specific situation of the patients