腹腔镜辅助下阴式子宫切除和阴式子宫全切术的疗效比较

目的比较腹腔镜辅助下阴式子宫切除和阴式子宫全切术的疗效。方法根据入院顺序将160例行择期全子宫切除术的患者分为治疗组与对照组（各80例）。对照组采用单独阴式子宫全切术,治疗组采用腹腔镜辅助下阴式子宫切除。结果两组患者的血糖与胰岛素均在麻醉后开始升高,并在T1点升至最高（P〈0.01）;治疗组血糖与胰岛素水平在T2、T3时点均明显高于对照组（P〈0.05）。治疗组的手术时间与出血量均明显少于对照组（P〈0.05）。两组均无持续性低热,可排除合并感染的情况。术后3个月门诊复查阴道残端愈合良好,患者无大小便困难与其它不适。结论与阴式子宫全切术相比,腹腔镜辅助下阴式子宫切除能够减少创伤,不增加并发症,有利于血糖与胰岛素的恢复,因此值得推广应用。

Comparison of therapeutic effect of iaparoscopy-assisted vaginal hysterectomy and total vaginal hysterectomy

Objective To compare therapeutic effect of laparoscopy-assisted vaginal hysterectomy and total vaginal hysterectomy.Methods One hundred and sixty patients scheduled for total hysterectomy were equally divided into treatment group and control group.The control group only received total vaginal hysterectomy,while the treatment group received laparoscopy-assisted vaginal hysterectomy.Results Blood sugar and insulin levels increased in both groups after anesthesia,which peaked at T1（P〈0.01）.Compared with the control group,the treatment group had significantly higher blood sugar and insulin at points T2 and T3（P〈0.05）.The treatment group featured significantly less operation time and bleeding（P〈0.05）.Neither group had persistent low fever,which excluded infection.Outpatient review conducted 3 months after the operation confirmed good healing of the residue vagina.Patients complained no difficulty or discomfort.Conclusion Compared with sole total vaginal hysterectomy,laparoscopy-assisted vaginal hysterectomy can reduce wound with few additional complications.It can also stabilize blood sugar and insulin.Therefore,its clinical application should be promoted.