不同途径子宫切除术的临床观察

目的:探讨经腹、经阴道、腹腔镜3种不同途径子宫切除术的临床选择。方法:回顾分析对比经腹、经阴道或腹腔镜3种不同途径子宫切除术患者的临床一般资料及术中、术后情况,比较3组患者的平均子宫体积、手术时间、术前及术后血红蛋白含量、术中出血量、手术并发症发生率、术后病率及术后住院天数等指标。结果:3组患者的年龄、疾病类型及术后第1天血红蛋白含量无明显差异。经阴道子宫切除术、腹腔镜子宫切除术的手术时间、出血量、术后病率、术后住院天数均优于经腹子宫切除术。经阴道子宫切除术的并发症明显低于经腹及腹腔镜子宫切除术。结论:子宫切除途径的选择,应优先考虑创伤小、恢复快、费用少,最有利于患者的切除途径,经阴道子宫切除术不失为较好的术式选择。

Clinical Investigation of Different Pathway of Hysterectomies

Objective:To evaluate the technical procedure and the clinical value of total abdominal,transvaginal and total lapa- roscopic hysterectomies.Methods:A total of 226 patients underwent hysterectomy from January 2005 to July 2006,the number of total abdominal hysterectomy(TAH),transvaginal hysterectomy(TVH)and total laparoscopic hysterectomy(TLH)were 118,55 and 53 respectively.The clinical data and parameters of patients which were mean capacity of uterine body,time of op- eration,volume of haematoglobin that before and after operation,volume of haemorrhage,complications of operation and hos- pital day were observed.Results:The mean age,the type of disease and volume of haematoglobin of the first day after opera- tion were no difference with the three hysterectomy procedures,The time of operation,volume of haemorrhage,incidence of illness and hospital day of TVH and TLH were less than TAH(P<0.01).The complication of operation after operation of TVH were de- creased obviously compared with TAH and TLH(P<0.01).Conclusion:Hysterectomy is one of the most commonly performed major surgical procedures,the decision about the transvaginal hysterectomy was a better route,because it is quicker and cheaper,shorter hos- pital stay and quicker return to normal activities,less complication rates than TAH and TLH.