阴式全子宫切除术与腹腔镜子宫切除术比较

目的探讨阴式子宫全切除术和腹腔镜子宫全切除术的临床效果。方法 2010年1月～2012年1月,在我院妇产科行阴式或腹腔镜子宫全切除术的患者(全部资料完整)共300例,其中154例非脱垂子宫行阴式子宫全切除术(TVH组),146例行腹腔镜子宫全切除术(LTH组),观察两组的手术时间、术中出血量、术后镇痛用药率、术后肛门排气时间、住院时间、住院费用及术中术后并发症。结果 TVH组手术时间较短,术中出血量较少,且在术后镇痛用药率、术后肛门排气时间、住院费用上均少于LTH组(P<0.05或P<0.01),两者比较差异有统计学意义(P<0.05),但在子宫重量、肌瘤或腺肌瘤最大直径、住院时间、手术并发症发生率上比较,差异无统计学意义(P>0.05)。结论应根据患者具体经济情况及病情选用相应的手术方式,在无手术禁忌症的情况下,尽可能选取兼顾微创、廉价而安全的阴式子宫全切除术。

Comparison of vaginal hysterectomy and laparoscopic hysterectomy surgery

Objective To investigate the vaginal hysterectomy and laparoscopic uterine full resection of the clinical effect. Methods From January 2010 to January 2012,the obstetrics and gynecology operated 300 cases of vaginal or laparoscopic hysterectomy patients,of which 154 cases of non-prolapsed uterus OK vaginal hysterectomy resection(TVH group),146 patients underwent laparoscopic uterine full resection(LTH group),two groups were observed in operative time,blood loss,postoperative analgesic medication rate,postoperative flatus,length of stay,cost of hospitalization and surgery and postoperative complications. Results The TVH Group had shorter operative time,intraoperative blood loss was less in the rate of postoperative analgesic medication,postoperative flatus,hospital costs were less than the LTH group(P<0.05 or P<0.01).the difference was statistically significant(P<0.05),but the maximum diameter of uterine weight,fibroids or adenomyosis,hospitalization time,incidence of complications,the difference was not statistically significant(P>0.05). Conclusions The appropriate surgical approach should be based on specific economic situation and condition,if there is no surgical contraindications,we should choose the minimally invasive,cheap and safe vaginal hysterectomy surgery.