不同入路单孔腹腔镜子宫全切术治疗子宫良性疾病的疗效比较

目的 比较不同入路单孔腹腔镜子宫全切术治疗子宫良性疾病的临床疗效.方法 选取2019年2月至2020年3月在阜阳市人民医院行子宫全切术治疗的72例子宫良性疾病患者,按随机数字表法将其分为观察组和对照组,各36例.观察组采用经阴道入路单孔腹腔镜子宫全切术,对照组采用经脐入路单孔腹腔镜子宫全切术,比较两组患者手术时间、术中出血量及术后不同时刻(6、12、24 h)疼痛评分、术后康复情况(包括术后排气时间、术后首次下床活动时间及术后住院时间),并发症(包括切口感染、血肿、发热)及伤口愈合不良率.结果 两组患者手术时间及术中出血量比较,差异均无统计学意义(P>0.05).两组患者不同时间点疼痛评分存在组间、时间、交互效应(P<0.05),观察组术后6、12及24 h疼痛评分及术后排气时间均低于对照组,差异均有统计学意义(P<0.05).两组患者术后首次下床活动时间、术后住院时间比较,差异均无统计学意义(P>0.05).两组患者并发症发生率及伤口愈合不良率比较,差异均无统计学意义(P>0.05).结论 经阴道入路与经脐入路单孔腹腔镜子宫全切术治疗子宫良性疾病均安全、有效,前者术后疼痛程度更轻、排气时间更短.

Comparison of clinical effects of different approaches of single port laparoscopic total hysterectomy in treatment of benign gynecological diseases

Objective To compare the clinical effects of different approaches of single port laparoscopic total hysterectomy in the treatment of benign gynecological diseases in women. Methods A total of 72 patients with benign uterine lesions who underwent hysterectomy in our hospital from February 2019 to March 2020 were selected and divided into the study group (vaginal approach) and the control group (umbilical approach) using a random number table method, with36 cases in each group. The operation time, intraoperative blood loss, pain scores at different times after surgery, and postoperative recovery were compared between the two groups. The incidence of complications and poor wound healing were compared between the two group sas well. Results There was no statistically significant difference in the operation time and intraoperative blood loss between the two groups (P>0.05). There was statistically significant difference in pain scores between the two groups at different time points after surgery (P<0.05). The pain scores of the study group at 6 h, 12 h, and 24 h after surgery were significantly lower than those of the control group (P<0.05). The postoperative exhaust time in the study group was significantly shorter than that in the control group (P<0.05). There was no statistically significant difference in the time of getting out of bed for the first time and the postoperative hospital stay between the two groups (P>0.05). There was no significant difference in the incidence of complications and poor wound healing between the two groups (P>0.05).Conclusions Transvaginal hysterectomy and transumbilical single-port laparoscopy are both safe and effective. However, compared with transumbilical single-port laparoscopy, patients with transvaginal approach have less postoperative pain and exhaust gas. The time is shorter.