改良腹腔镜辅助阴式子宫切除术治疗效果观察

目的：探讨大子宫患者应用改良腹腔镜辅助阴式子宫切除术（ MLAVH）切除子宫的效果。方法选取湖北医药学院附属东风医院2011年9月至2016年3月期间收治的子宫肌瘤或子宫腺肌病患者185例，根据是否施行改良腹腔镜辅助阴式子宫切除术，将185例患者分为对照组（n＝92）和实验组（n＝93），分别采取改良腹腔镜辅助阴式子宫切除术与传统经腹子宫切除术进行治疗，对比分析两组患者在手术中的出血量、肛门排气时间及术后疼痛情况。结果185名子宫肌瘤或子宫腺肌病患者均成功手术。实验组的术中出血量显著少于对照组（t＝11．171，P＜0．001），且肛门排气时间、手术时间均显著缩短（t值分别为11．294、4．218，均P＜0．001）。两组患者术后疼痛分级有显著性差异（χ2＝71．330，P＜0．001），实验组的术后疼痛情况在Ⅰ级、Ⅱ级居多，而对照组Ⅲ级最多。结论改良腹腔镜辅助阴式子宫切除术更加方便、有效，对患者围手术期、预后等质量有显著提高。

Observation of the effect of modified laparoscopic-assisted vaginal hysterectomy

Objective To explore the application effect of modified laparoscopic-assisted vaginal hysterectomy ( MLAVH) on the resection of big uterus .Methods Totally 185 patients with uterus myoma or adenomyosis admitted during the period of September 2011 to March 2016 in Dongfeng Hospital of Hubei University of Medicine were randomly divided into control group ( n=92 ) and experimental group (n=93).The control group accepted conventional total abdominal hysterectomy (TAH) and the experimental group accepted MLAVH. Two groups were compared in intraoperative blood loss , anal exhaust and postoperative pain .Results All surgeries were successful in 185 cases.Compared to the control group, the experimental group has less intraoperative blood loss (t=11.171, P<0.001), short anal exhaust and operative duration (t value was 11.294 and 4.218, respectively, both P <0.001).There was significant difference in postoperative pain grade between two groups (χ2 =71.330, P <0.001).There were more cases with grade I and grade II in the experimental group , while cases with grade III were more in the control group .Conclusion MLAVH is more convenient and effective , and it can improve perioperative situation and prognosis of patients significantly .