腹腔镜辅助阴式与经腹全子宫切除术治疗大子宫的对照研究

目的比较腹腔镜辅助子宫切除术(LAVH)和经腹全子宫切除术(TAH)治疗大子宫的临床疗效,为大子宫肌瘤的术式选择提供指导。方法选取1997年10月—2005年5月间因子宫肌瘤(子宫>如孕12周)行全子宫切除的240例患者,其中120例行TAH,120例行LAVH,两组病例术前一般情况相似。比较两组手术时间、术后抗生素应用时间、术后住院天数、术中出血量、术后镇痛与否、术后有无并发症等指标。结果LAVH组抗生素使用时间及术后住院时间较TAH组短;术中出血量较TAH组少;术后疼痛较TAH组轻。两组术式在术后并发症方面无明显差异,但LAVH组手术时间较TAH组长。结论LAVH行大子宫切除,是一种安全、疗效确切的手术方式,同时体现了创伤小、恢复快的优点。

Study of Comparing Laparoscopic-assisted Vaginal Hysterectomy and Total Abdominal Hysterectomy for Treatment of Large Uterus

Objective To compare the clinical results between laparoscopic-assisted vaginal hysterectomy(LAVH) and total abdominal hysterectomy(TAH) in order to provide valuable information for choosing correct treatment of large uterus.Methods Two hundred and forty patients with large uterus were collected from Oct.1997 to May 2005.They were divided into two groups,i.e.LAVH group(n=120) and TAH group(n=120).Some indexes were recorded,such as duration of operation,antibiotic administration and hospitalization,as well as bleeding volume during operation,and postoperative paregoric administration and complications.The data were analyzed by statistical means.Results There were significant differences between the two groups in the duration of antibiotic administration(LAVH 5.2±0.7,TAH 8.5±1.2 days) and hospitalization(LAVH 6.6±0.9,TAH 11.3±1.4 days),and in postoperative paregoric administration and bleeding volume during operation.Better outcome were found in LAVH group.There was no significant difference between the two groups in the occurrence of complications after operation(LAVH 4.2%,TAH 5.0%).Conclusion Laparoscopic-assisted vaginal hysterectomy is a safe and effective operation method to large uterus.