子宫动脉先处理方法在腹腔镜下子宫切除术中的应用分析

 目的 评价腹腔镜鞘膜内子宫切除术 (LISH)，腹腔镜全子宫切除术(LTH)中先处理子宫动脉在手术中的作用。方法 将301例需要子宫切除的患者分成两组：A组（常规组）和B组（子宫动脉先处理组）。手术方式为LISH(174例)和LTH（127例），将手术时间、出血量、并发症及术后恢复等情况的比较分析。结果 A组和B组中LISH和LTH的手术时间，出血量，术后体温，肛门排气时间，住院时间相比较，两组手术时间比较无统计学意义（p＞0.05），两组出血量比较有统计学意义（ｐ＜0.01），两组术后体温，肛门排气以及住院时间比较无差异性（p＞0.05）。术中，术后并发症发生率比较：A组LISH发生率6.8%， B组LISH发生率3.4%，两者比较有差异性（ｐ＜0.01）。A组LTH发生率0.7%，B组发生率LTH为0.7%，比较无差异性（p＞0.05）。LISH和LTH两种手术方式比较，A组和B组手术时间和术中出血量比较有差异性（ｐ＜0.01），术后体温，肛门排气和住院天数比较无差异性（p＞0.05）。结论 子宫动脉先处理在LISH和LTH中可以有效减少出血量，并且减少术中并发症的发生。但是对于子宫较大的患者，该术式的选择应该谨慎。

Clinical Significance of the Pretreatment of Uterine Arteries before Laparoscopic Hysterectomy

Objective To evaluate the clinical efficacy of first cutting uterine artery in different operative patterns of laparoscopic hysterectomy. Laparoscopically introfasial subtotal hysterectomy(LISH), Laparoscopically total hysterectomy(LTH). Methods A (normal group) and B (first cutting uterine artery group),A retrospective on 301 cases of laparoscopic hysterectomy was carried out,including operating time,blood loss,complication and postoperative recovery. Results For the A groups LISH was performed 93 cases and LTH was 68 cases,with an operating time,blood loss,complication rate. For the B group,LISH was performed 81 cases and LTH was 59 cases,,with an operating time,blood loss,complication rate..The difference between the LISH two groups was significant in blood loss and complication（ｐ＜0.01）.The no difference between the two LTH groups was significant blood loss and complication (p＞0.05）.The no difference between the two groups was significant in operating time, and postoperative recovery with A and B （p＞0.05）. Conclusions The way of pretreatment of uterine arteries is an ideal skill for Laparoscopic hysterectomy,But the treatment should be individualized.