阴式全子宫切除术与腹腔镜辅助下阴式全子宫切除术的比较

目的比较阴式全子宫切除术与腹腔镜辅助下阴式全子宫切除术的临床效果。方法回顾性分析2011年1月至2012年10月于第二军医大学长征医院南京分院妇产科行子宫切除术的79例患者的临床资料,其中行阴式全子宫切除治疗的39例患者为A组,腹腔镜辅助下阴式全子宫切除术治疗的40例为B组,比较两组患者的临床特征以及治疗情况。结果 A组患者盆腔粘连、伴发附件疾病的发生率分别为28.2%、23.1%,均显著高于B组患者的10.0%、5.0%（χ2=4.255、5.384,P〈0.05）;A组患者的手术时间（62.4±8.7）min]、术中出血量（82.3±17.5）mL]均显著少于B组患者（90.2±10.4）min、（97.2±21.0）mL]（t=12.870、3.421,P〈0.05）;两组患者并发症的发生情况比较无统计学意义（P〉0.05）。结论阴式全子宫切除术与腹腔镜辅助下阴式全子宫切除术均能够获得满意的临床效果,前者手术操作方便、但适应证具有局限性,后者则扩大了适应证的范围,需要根据患者具体病情选择适合的手术方案。

Comparison of Vaginal Hysterectomy and Laparoscopic-assisted Vaginal Hysterectomy

Objective To compare the clinical efficacy of vaginal hysterectomy and laparoscopic-assisted vaginal hysterectomy. Methods Total of 79 patients with hysterectomy from Nanjing Branch of Changzheng Hospital Affiliated to the Second Military Medical University during Jan. 2011 and Oct. 2012 were analyzed retrospectively,39 cases with vaginal hysterectomy as group A and 40 cases with laparoscopic-assisted vaginal hysterectomy as group B,the clinical features and treatment data of the two groups were compared. Results The rate of pelvic adhesions and associated with adnexal diseases of group A were 28. 2% and 23. 1%,significantly higher than 10. 0% and 5. 0% of group B（ χ2= 4. 255,5. 384,P 0. 05）. The operative time of group A（ 62. 4 ± 8. 7） min] and blood loss （ 82. 3 ± 17. 5） ml] were significantly lower than group B （ 90. 2 ± 10. 4） min,（ 97. 2 ± 21. 0） mL]（ t = 12. 870,3. 421,P 0. 05）,the complication rate of group A and group B had no statistically significant difference（ P 0. 05）. Conclusion Vaginal hysterectomy and laparoscopic-assisted vaginal hysterectomy are able to obtain satisfactory clinical results and good safety,the former is featured with convenient operation,but limited indications,while the latter is featured with expanded range of indications,therefore appropriate surgical program should be selected in accordance with the patient＇s specific condition.