腹腔镜全子宫切除术与腹腔镜辅助阴式全子宫切除术后对盆底功能的影响

目的 观察腹腔镜全子宫切除术和腹腔镜辅助阴式全子宫切除术后对患者盆底功能的影响.方法 回顾性分析2007年10月至2013年1月在中山大学附属第三医院行子宫切除术的患者94例,其中行腹腔镜全子宫切除术的46例患者为观察组,同期进行腹腔镜辅助阴式全子宫切除术的48例患者为对照组,比较两组手术情况及术后1～6年女性盆底功能障碍性疾病（PFD）发生率.结果 观察组患者与对照组患者的手术时间、术后肛门排气时间与住院天数无明显差别（P＞0.05）.观察组患者阴道顶端脱垂、膀胱及直肠膨出及压力性尿失禁发生率均高于对照组,但差异无明显的统计学意义（P＞0.05）.结论 腹腔镜全子宫切除术手术创伤小,结合阴道操作或者采取腹腔镜下阴道骶骨固定术可改善盆底功能.

Comparison of laparoscopy-assisted vaginal hysterectomy and total laparoscopic hysterectomy on pelvic floor function

Objective To observe the influence of the total laparoscopic hysterectomy and laparoscopy-assisted vaginal hysterectomy on pelvic floor function.Method From October 2007 to January 2013,94 patients underwent hysterectomy in the Third Affiliated Hospital of Sun Yat-sen University.46 patients who underwent laparoscopic hysterectomy were included in the observation group,compared with 48 patients who underwent laparoscopy-assisted vaginal hysterectomy in the control group at the same stage,the incidence of pelvic floor dysfunction（PFD） was observed after 1 to 6 years.Results The operation time,postoperative anal exsufflation time,duration of hospital stay of observation group were shorter than the control group,but the difference was not significant （P〉0.05）.The incidence of top vaginal prolapse,bladder and rectal prolapse and stress urinary incontinence of observation group were higher than the control group,but the difference was not significant （P〉0.05）.Conclusion Total laparoscopic hysterectomy would be an operation with less trauma,less influence on pelvic floor function and worthy of clinical application.