腹腔镜下子宫切除术不同术式临床效果分析

目的评价4种腹腔镜下子宫切除术式的临床效果.方法64例行腹腔镜下子宫切除的患者,按不同手术方式分为CISH组、LSH组、TLH组和LAVH组,比较4组的术中和术后恢复情况及并发症发生情况.结果LSH组的手术时间、术中出血量和术后排气时间,均明显少于其他三组(P＜0.05);CISH组与TLH和LAVH组比较,在手术时间和术中出血量上均无显著性差异(P＞0.05);TLH组和LAVH组,在手术时间上有显著性差异(P＜0.05),在术中出血量上无明显差异(P＞0.05);除TLH组1例膀胱损伤外,其余病例均无严重术中和术后并发症发生,术后随访情况良好.结论4种术式均为腹腔镜下子宫切除的有效术式,各有利弊,应根据患者的具体情况进行选择.

Analysis of different operative patterns of laparoscopic hysterectomy

Aim To evaluate the clinical efficiency of four different operative patterns of laparoscopic hysterectomy. Methods The 64 cases of laparoscopic hysterectomy had been divided into 4 groups according to their different operative patterns. CISH was performed 25 cases. LSH was conducted in 14 cases. TLH was performed 20 cases and LAVH was carried out in 5 cases. Results The operating time, amount of blood loss and time to first flatus of LSH group were significant lower than the other three groups. There was no significant difference between CISH group and TLH group. The operating time of TLH group was significant shorter than that of LAVH group , but there was no significant difference of blood loss between the two groups. Except for 1 case with bladder injury in TLH group, the total patients had no serious complication. All patients recovered well postoperatively. Conclusions The four operative patterns are ideal for hysterectomy. The selection is based on the patients individual conditions.