腹腔镜辅助与阴式子宫切除术的对比研究

目的:探讨腹腔镜辅助阴式子宫切除术的临床疗效.方法:回顾分析2010年2月至2012年2月为125例患者行腹腔镜辅助阴式子宫切除术(laparoscopic assisted vaginal hysterectomy,LAVH)的临床资料,并与同期117例阴式子宫切除术(transvaginal hysterectomy,TVH)进行对比分析.结果:两组患者手术时间、术中出血量差异有统计学意义(P＜0.05);术后3天平均体温、术后肛门排气时间、术中严重并发症及术后住院时间两组相比差异无统计学意义(P＞0.05).结论:两种术式均符合微创医学理念,各有优缺点.LAVH视野清晰,可发现并处理盆腔内其他病变;TVH利用阴道自然腔道施术,无需复杂、昂贵的仪器,术者只需具备熟练的手术技巧.根据患者自身情况、盆腔有无粘连及粘连程度、是否涉及附件手术,并结合术者手术技巧选择最适宜的手术方式,可最大限度地减少术中并发症.

Comparative study between laparoscopic assisted vaginal hysterectomy and transvaginal hysterectomy

Objective:To discuss the clinical effects of laparoscopic assisted vaginal hysterectomy(LAVH).Methods:The clinical data of 125 cases who underwent LAVH from Feb.2010 to Feb.2012,and that of 117 patients who underwent transvaginal hysterectomy(TVH) was analyzed retrospectively and comparatively.Results:The operation time and blood loss during operation were(45.32±15.63) min and(72.45±26.35) ml in the LAVH group,and(68.57±18.63) min and(104.56±32.76) ml in the TVH group.And there were significant differences between the two groups(P<0.05).No significant difference was found between the LAVH and TVH groups in the average of body temperature during the postoperative three days,the exhausting time,intraoperative severe complications and postoperative hospital stay(P>0.05).Conclusions:Both LAVH and TVH are effective and mini-invasive myomectomy,and have advantages and disadvantages.LAVH has limpid visual field,can find and deal with other pathological changes in pelvic cavity;TVH is applied through natural orifice-vagina,does not need complex and expensive equipment,proficient operative skill is the only thing needed in this procedure.The operation method should be chosen according to the patient’s condition,whether or not there is pelvic adhesion,adnexa operation and adhesion degree,and the operator’s skills,so as to minimize the intraoperative complications.