三种不同子宫全切手术方式的临床探讨

目的探讨经腹全子宫切除术（TAH）、腹腔镜辅助阴式全子宫切除术（LAVH）和腹腔镜下子宫切除术（LTH）三种不同手术方式的临床效果。方法回顾性分析我院从2008年1月～2012年1月的TAH78例、LAVH69例、LTH53例的临床资料，其中TAH患者为对照组，并对其术中所需时间、术中出血量、术后切口疼痛、术后最高体温、肛门排气时间、住院时间、术后并发症等情况进行对照分析。结果对照组、LAVH组和LTH三组之间平均手术失血量无明显变化，差异无统计学意义（P〉0．05）。与对照组、LAVH组比较。LTH组手术时间明显增加，差异有统计学意义（P〈0．01）；与对照组比较，LAVH组和LTH组在术后疼痛、术后最高体温、排气时间、住院时间均减少，住院费用增加，差异有统计学意义（P〈0．05）；与LAVH比较，LTH组术后疼痛、排气时间明显增加，差异有统计学意义（P〈0．05）；与对照组、LAVH比较，LTH组术后并发症明显升高，差异有统计学意义（P〈0．01）。结论LAVH组和LTH组均具有微创、术后疼痛轻、恢复快、住院时间短等优点，但LAVH组利用经阴式子宫切除术及LTH的微创优点，减少了手术并发症，在临床上具有较好的应用前景。

Study on three typs of total hysterectomy for uterus

Objective To investigate the clinical effects of three kinds of hysterectomy. Methods Seventy-eight women undergoing transabdominal hysterectomy（TAH） as control group, 69 women undergoing laparoseopically assisted vagi- nal hysterectomy（LAVH）, 53 women undergoing to laparoseopie hysterectomy（LTH） from Jan 2008 to Jan 2012 were studied retrospectively, The intraoperative time, blood loss, postoperative pain, postoperative maximum temperature, ex- haust time,surgical complications and hospitalization time were compared. Results There were no difference in mean operative blood loss （P 〉 0.05）. In contrast with control group and LAVH group, LTH group existed significantly in- creased in the the operative time（P 〈 0.01 ）. The postoperative pain, postoperative maximum temperature, exhaust time and hospitalization time in LAVH group and LTH group were less than the control group obviously（P 〈 0.05）, but the Hospitalization costs on the contrary. In contrast with LAVH group, LTH group existed significantly increased in the the postoperative pain and exhaust time（P 〈 0.05）. In contrast with control group and LAVH group, LTH group exist- ed significantly increased in the postoperative complications （P 〈 0.01 ）. Conclusion In contrast with control group, LAVH groups and LTH group have the advantages in trauma, postoperative pain, recovery, shorter hospital stay and hospitalization time. LAVH group has used the advantages of control group and LTH group, reducing surgical compli- cations, with better clinical application prospects.