比较结扎速血管闭合系统与双极电凝在腹腔镜子宫切除术中的应用

目的 比较结扎速血管闭合系统与普通双极电凝在腹腔镜子宫切除术时凝固闭合卵巢和子宫血管的效果。方法 对60名患者术中分别用结扎速血管闭合系统、普通双极电凝闭合左、右侧骨盆漏斗韧带内的卵巢血管、子宫血管及卵巢固有韧带内的子宫动脉上行支,比较二种不同电器械凝固卵巢血管、子宫血管后的血管闭合情况、切断后止血效果及热损伤的发生。结果 结扎速血管闭合系统、普通双极电凝均能有效凝固、闭塞<3mm管径的血管,二者止血效果相仿(P>0.05);但在凝固、闭合3～5mm直径的子宫、卵巢血管时二者血管腔闭合效果有明显差异(P<0.05)。结扎速、普通双极均有热能向周围组织传导,但未造成邻近器官热损伤的发生。结论 结扎速、普通双极电凝均能安全有效凝固<3mm直径的血管,结扎速凝固闭合3～5mm的较大血管更安全、更有效。

Comparison on Application of Ligasure Vessel Sealing System and Bipolar Electric Coagulation in Laparoscopic Hysterectomy

Objective To compare the effects of ligasure vessel sealing system and bipolar coagulation on the occlusion of ovarian and uterine vessels during laparoscopic hysterectomy. Method In sixty patients accepting laparoscopic hysterectomy, ligasure vessel sealing system was applied to occlude the left side ovarian and uterine vessels, while bipolar coagulation to coagulate the right side ovarian and uterine vessels during the operation. The vessel occlusion, hemostasis and the occurrence of thermal damage were compared. Results Both ligasure and bipolar could effectively coagulate the vessels smaller than 3mm. Their hemostasia effects were similar( P>0.05). But there were significant differences between two methods in the occlusion effects on ovarian and uterine vessels whose diameters were 3~5mm( P<0.05). Both of them produced no thermal damage to surrounding tissue. Conclusions Ligasure and bipolar could effectively coagulate the vessels whose diameters were <3mm. Ligasure can occlude the large vessel(3~5mm) more safely and effectively than Bpolar.