腹腔镜下大子宫次全切除术的临床观察

目的探讨腹腔镜下大子宫次全切除术的技巧和临床意义。方法回顾分析2007年7月至2011年3月在该院妇科行腹腔镜下大子宫次全切除术35例(A组)与开腹大子宫次全切除术30例(B组)患者的临床资料,比较两组的手术时间、术中出血量、术后肛门排气时间、下床时间、使用镇痛药例数及住院时间、费用等情况。结果两组出血量无明显差异(P=0.070 4),但A组手术时间较B组长(P=0.003 0),术后肛门排气时间、术后下床时间、术后使用镇痛药例数、住院天数均少于B组,两组均无严重手术并发症。结论 A组疗效明显优于B组,子宫大于12孕周的患者不是腹腔镜手术的绝对禁忌证,只要操作技巧熟练,腹腔镜下大子宫全切除术仍然是一种安全、可行的手术方式。

Clinical observation on laparoscopic subtotal hysterectomy with large uterus

Objective To explore the skill and clinical significance of laparoscopic subtotal resection of large uterus.Methods Clinical data of 35 cases of laparoscopic subtotal resection of large uterus(Group A) and 30 cases of open resection of large uterus(Group B),which had been hospitalized in our hospital from July 2007 to March 2011,were analyzed retrospectively.Operative time,blood loss,postoperative flatus time,postoperative ambulation time,number of patients using analgesics,hospitalization time,and cost of the two groups were compared and analyzed.Results The two groups showed no significant difference in bleeding(P=0.070 4),but the operation time of Group A was longer than that of Group B(P=0.003 0).Postoperative flatus time,postoperative ambulation time,the number of patients using postoperative acesodyne,length of hospital stay were less than those of Group B.There was no serious complication in both groups.Conclusion Group A takes obvious advantages in therapeutic effect than Group B.Uterus greater than 12 weeks pregnancy is not absolute contraindications for laparoscopic surgery,as long as surgical technique is proficient.Laparoscopic subtotal hysterectomy with large uterus is a safe and feasible surgical approach.