三种子宫全切术式临床疗效比较

目的 比较开腹全子宫切除术(TAH)、腹腔镜辅助下阴式全子宫切术(LAYS)和经阴道全子宫切除术(TVH)的临床应用情况及临床效果.方法 回顾性分析710例全子宫切除术患者临床资料,其中TAH 397例,LAVH 176例,TVH 137例.结果 子宫体积、盆腔手术史、盆腔粘连是影响术式选择的主要因素,TAH组与LAVH、TvH组比较差异有统计学意义(p<0.05).各组间手术时间、术中出血量、手术并发症、术后肛门排气时间两两比较差异均有统计学意义(均P<0.05).结论 子宫体积、盆腔手术史和盆腔粘连是影响术式选择的主要因素.TVH是三种术式中创伤最小、术后病率最低、恢复最快且最经济的一种术式.但LAVH手术视野清晰,可降低阴式手术操作难度,扩大阴式子宫切除术适应证.

Clinical analysis of different hysterectomy approaches on 710 cases

Objective To compare the clinical effects of total abdominal hysterectomy(TAH), laparoscopic vaginal hysterectomy(LAVH) and transvaginal hysterectomy(TVH). Methods A retrespective analysis was conduc-ted in 710 women underwent different hysterectomy approaches,includlng 397 patients underdoing TAH,176 underdo-ing LAVH and 137 treated with TVH. Results Uterine volume, operative pelvis, pelvic adhesion were main factors infulencing different operative styles for hysterectomy ( P<0.05 ). Compared with TAH, LAVH, TVH, the operation time,blood loss ,operation complicafion and recovery time of intestinal function were significantly difference(P<0.05). Conclusion Uterine volume, pelvic adhesion, operative pelvis were major factors influencing different operative styles for hysterectomy. The clinical efficacy of TVH is best,which is less time, minimal invasion, shorter recovery time and lower cost. The application of LAVH provides a promising microinvasive approach for vaginal hysterectomy which can make operation easy, visual field clear and is worthy to be advocated too.