腹腔镜下子宫切除术不同术式的临床应用

目的探讨4种不同途径腹腔镜下子宫切除术的临床应用。方法回顾性分析208例腹腔镜子宫切除术患者的临床资料，其中腹腔镜辅助阴式子宫切除术（LAVH）83例、腹腔镜下全子宫切除术（TLH）64例、腹腔镜下筋膜内子宫切除术（CISH）35例、腹腔镜下子宫次全切除术（LSH）26例，比较各组患者术中及术后的情况。结果平均手术时间LAVH组（115．60±22．81）min，TLH组（135．36±28．11）min，CISH组（103．69±19．18）min，LSH组（84．23±18．42）min，术中出血量LAVH组（130．44±27．35）组ml，TLH组（143．55±29．86）ml，CISH组（103．84±31．72）ml，LSH组（80．29±21．41）ml，LSH组与其它组比较，差异均有统计学意义（P〈O．051。结论不同途径腹腔镜子宫切除术各有优势，且互不能完全替代，应根据患者的情况、手术医生的技术水准、医院的条件等综合考虑。

Clinical study on different operation procedure for laparoscopic hysterectomy

Objective To investigate the effects of four laparoscopic hysterectomy. Methods From February 2006 to March 2009, 208 cases of laparoscopic hysterectomy inpatients were retrospectively analyzed, Clinical characteristics were analyzed among laparoscopie assisted vaginal hysterectomy group （LAVH, 83 cases）, total laparoscopic hysterectomy group （TLH, 64 cases）, classic intrafascial SEMM hysterectomy group （CISH, 35 cases）, laparoscopic super cervical hysterectomy group （LSH, 26 cases）. Resuts The average operation time of LAVH, TLH, CISH and LSH was （ 115.60 ± 22.81 ） minutes, （ 135.36 ± 28.11 ） minutes, （ 103.69 ± 19.18 ） minutes and （ 84.23 ± 18.42 ） minutes. The volume of hemorrhage during operation of LAVH, TLH, CISH and LSH was （ 130.44 ± 27.35 ） ml, （ 143.55 ± 29.86 ） ml, （ 105.84 ± 31.72 ） ml and （ 80.29 ± 21.41 ） ml. The average operation time and volume of hemorrhage during operation in LSH groups were significantly less than that of other three groups. Conclusion Different procedures for laparoscopic hysterectomy have their own advantages and disadvantages. Microinvasive surgery by laparoscopy for hysterectomy will he mainstream in the future.