改良主骶韧带免缝扎法腹腔镜辅助阴式大子宫切除术的临床分析

目的 比较改良主骶韧带免缝扎法腹腔镜辅助阴式大子宫切除术与传统腹式大子宫切除术治疗大子宫的临床效果.方法 收集206例大子宫(子宫≥妊娠12周)患者的临床资料,其中行改良主骶韧带免缝扎法腹腔镜辅助阴式大子宫切除术106例(观察组),传统腹式大子宫切除术100例(对照组),比较两组患者的围手术期情况.结果 观察组肛门排气时间、术后住院时间、术后疼痛时间[(25.4±3.3)h、(6.5±1.5)d、(16.9±2.4)h]明显短于对照组[(42.4±5.3)h、(8.5±1.5)d、(30.6±5.3)h](P＜0.05),观察组并发症发生率[5.7％(6/106)]明显低于对照组[10.0％(10/100)](P＜0.05).结论 大子宫切除时采用改良主骶韧带免缝扎法腹腔镜辅助阴式大子宫切除术优于传统腹式大子宫切除术,技术相对易掌握,手术时间短且并发症少.

Clinical study of reformed laparoscopic-assisted vaginal hysterectomy of large uterus with sutureless of cardinal and uterosacral ligament

Objective To compare the clinical efficacy between reformed laparoscopic-assisted vaginal hysterectomy with sutureless of cardinal and uterosacral ligament(LAVH)and trans abdominal hysterectomy(TAH)for large uterus.Methods A retrospective study was performed using 106 reformed LAVH patients(observation group)and 100 TAH patients(control group)whose uterus were big(≥ 12weeks of gestation),the information was observed in perioperative period.Results Anal exsufflation time,hospitalization time after operation and postoperative pain time in observation group[(25.4 ± 3.3)h,(6.5 ±1.5)d,(16.9 ± 2.4)h]were significantly shorter than those in control group[(42.4 ± 5.3)h,(8.5 ± 1.5)d,(30.6 ± 5.3)h](P ＜ 0.05),the rate of complication in observation group[5.7％(6/106)]waa lower than that in control group[10.0％(10/100)](P＜ 0.05).Conclusion As to large uterus,reformed LAVH has several advantages over TAH,the technique is easy to learn,operation time is short,and the rate of complication is low.