四种子宫切除术临床效果比较

目的比较传统腹式子宫切除术（TAH）、阴式子宫切除术（TvH）、腹腔镜辅助阴式子宫切除术（LAVH）、腹腔镜下全子宫切除术（LTH）等四种子宫全切术的临床效果。方法回顾性分析568例的患者临床资料，其中TAH组218例、TvH组138例、TVHL组145例、LTH组67例，比较四组患者术中、术后相关指标情况。结果手术时间（min）：TAH组、TvH组、TVHL组、LTH组分别为：（76．4±15．3）、（68．2±10．5）、（82．3．4-14．6）、（120．7±30．4）；术中出血量（m1）：TAH组、TVH组、TVHL组、LTH组分别为：（145．4±53．1）、（96．3±30．5）、（56．2±21．3）、（20．2±11．3）；术后排气时间（h）：TAH组、TVH组、TVHL组、LTH组分别为：（36．24-12．1）、（12．3±4．5）、（10．4±2．8）、（9．8±2．4）；住院时间（d）：TAH组、TvH组、TVHL组、LTH组分别为（8．3±2．3）、（5．4±0．8）、（5．3±0．9）、（5．6±0．8）。LTH组手术时间与其他三组差异有统计学意义（x2=5．26、8．26、6．42，均P〈0．05）；TAH组术中平均出血量与其他三组差异有统计学意义（x2=7．38、8．12、13．81，均P〈0．05）；TAH组肛门排气时间较其他三组长（x2=4．16、6．54、8．33，均P〈0．05）。结论TVH和LAVH、LTH具有术中出血少、术后恢复快、平均住院时间短及患者对手术满意度高等优点。

Comparison of the clinical effects of four kinds of hysterectomy

Objective To compare the clinical effect of the traditional abdominal hysterectomy（ TAH）, vagi- nal hysterectomy （ TVH ）, laparoscopic assisted vaginal hysterectomy （ LAVH ）, total laparoscopic hysterectomy （ LTH ）. Methods The clinical data of 568 patients were retrospectively analyzed. 218 patients were in TAH group, 138 cases in TVH group, 145 cases in TVHL group,67 cases in LTH group. The intraoperative and postoperative indicators were compared among the four groups. Results Operation time （min） of the TAH,TVH, TVHL, LTH group was （76.4± 15.3 ）, （68.2 ± 10.5 ）, （ 82.3 ± 14.6）, （ 120.7 ±30.4）, respeetively. Intraoperative blood loss （ml） in TAH, TVH,TVHL, LTH group was （ 145.4 ±53.1 ）, （96.3 ± 30.5 ）, （56.2 ± 21.3 ）, （20.2 ± 11.3 ）, respectively. Exhaust time after operation （h） in TAH, TVH, TVHL, LTH group was （ 36.2 ± 12.1 ）, （ 12.3 ± 4.5 ）, （ 10.4 ±2.8 ）, （ 9.8 ± 2. 4） , respectively. The hospitalization time （d） in TAH, TVH, TVHL, LTH group was （ 8.3 ± 2.3 ）, （ 5.4 ± 0.8 ） , （ 5.3 ± 0.9 ）, （ 5.6± 0.8 ）, respectively. The operation time of LTH group had significant differences compared with the other three groups （ X2 = 5.26,8.26,6.42, all P 〈 0.05 ）. The mean intraoperative blood loss of TAH group had significant differences compared with the other three groups （X2 = 7.38,8.12,13.81, all P 〈 0.05 ）. The anal exhaust time of TAH group was longer than the other three groups （ X2 = 4. 16,6. 54,8. 33, all P 〈 0.05 ）. Conclusion TVH, LAVH and LTH have advantages of less blood loss, faster postoperative recovery, shorter hospitalization time and high- er patients＇satisfaction.