非脱垂子宫阴式子宫全切除术、气腹腹腔镜辅助阴式子宫全切除术与开腹子宫全切除术的疗效比较

目的探讨非脱垂子宫阴式子宫全切除术(TVH)、气腹腹腔镜辅助阴式子宫全切除术(LAVH)与开腹子宫全切除术(TAH)三种术式的临床应用价值。方法选择2004年6月至2008年5月老河口市第一医院收治的因子宫肌瘤行子宫全切除术的患者155例,并按照手术方式的不同将其分为三组:TVH 45例(阴式组),LAVH 50例(腹腔镜组),TAH 60例(开腹组)。对比分析三种术式的手术时间、术中出血量、术后排气时间、术后镇痛情况、术后住院天数等情况。结果开腹组手术时间较阴式组长(P<0.05),较腹腔镜组短(P<0.05);开腹组术中出血量较其他两组多(P<0.05);开腹组术后需要上止痛药的例数多,术后恢复排气时间和住院天数长,与其他两组比较差异有统计学意义(P<0.05);三组总治疗费用比较差异无统计学意义(P>0.05)。结论 TVH、LAVH是行子宫全切术较理想的术式,腹腔镜辅助降低了经阴式子宫全切术的难度,扩大了阴式子宫全切术的手术范围,患者创伤小,术后恢复快。

Efficacy Comparison of Transvaginal Hysterectomy,Pneumoperitoneum Laparoscopic-assisted Vaginal Hysterectomy and Total Abdominal Hysterectomy for Non-prolapsed Uterus

Objective To explore the clinical application value of transvaginal hysterectomy(TVH),pneumatic laparoscopic assisted vaginal hysterectomy(LAVH)and total abdominal hysterectomy(TAH) fro non-prolapsed uterus.Methods 155 cases from Laohekou First Hospital from Jun.2004 to May 2008,who received hysterectomy because of uterine fibroids were selected and divided into three groups according to the operation method:TVH 45 cases,LAVH 50 cases,TAH 60 cases.Operative time,blood loss,postoperative exhaust time,postoperative analgesia,and postoperative hospital days of the three groups were compared.Results The operation time of TAH group was longer than TVH group(P<0.05),but shorter than LAVH group(P<0.05);blood loss of TAH group was more than the other two groups(P<0.05);more case needing pain killers,longer postoperative exhaust time and longer postoperative hospital stay in TAH group than the other two groups(P<0.05);there was no statistically significant difference in the total treatment cost between the three groups(P>0.05).Conclusion TVH,LAVH are ideal procedures for hysterectomy.Laparoscopic-assisted manner reduces the difficulty of vaginal hysterectomy and expands the scope of the vaginal hysterectomy surgery with little trauma to patients and rapid postoperative recovery.