腹腔镜辅助阴式子宫切除术的临床应用

目的旨在探讨腹腔镜辅助阴式子宫切除术（LAVH）的临床应用，并与腹式子宫切除术（TAH）进行比较。方法将2009年1月～2010年12月在我院进行子宫切除术的162例患者设立为研究对象，随机分为两组，其中行LAVH81例，设立为观察组，余81例行TAH，设立为对照组，观察记录两组患者手术期间手术时间、术中出血量、术后患者肛门排气时间及住院时间以及术后发热、应用止痛药物率等。结果观察组术后发热5例，应用止痛药物8例．对照组术后发热16例，术后应用止痛药物74例，两组术后发热率（6．17％vs19．75％）及应用止痛药物率（9．88％vs91．36％）比较，差异具有统计学意义（P〈0．05或P〈0．01）。观察组手术时间（114．38±12．39）min，与对照组比较无明显差异，观察组术中出血量（90．5±12．6）mL，明显少于对照组，观察组患者术后排气时间（19.3±5．2）h，明显快于对照组，观察组患者住院时间（5．2±1．1）d，明显短于对照组，差异具有显著性（P〈0．05）。结论腹腔镜辅助阴式子宫切除术具有创伤小、术后恢复快、并发症少等优点，值得推广和应用。

The clinical application of laparoscopically assisted vaginal hysterectomy

Objective To investigate the effect of laparoscopically assisted vaginal hysterectomy, and to compare with abdominal hysterectomy. Methods Selected 162 patients hysterectomy, 81 patients were given LAVH,established the observation group,and the remaining 81 patients were given abdominal hysterectomy ,established the control group,the operative time,blood loss, postoperative anal exhaust time and length of hospital stay and postoperative fever, applica- tion rate and other pain medications were compared. Results The postoperative 5 cases,the application of pain medi- cations 8 cases, 16 cases of postoperative fever in control group, 74 cases of postoperative pain medications in control group, postoperative fever rate（6.17% vs.19.75%） and the rate of application of pain medications （9.88% vs 91.36%） had significant differences between two groups （P〈0.05 or P〈0.01）. The operation time of observation group was 114.38± 12.39min, had no significantly difference compared with the control group, the blood loss of theobservation group was 90.5±12.6 mL, was significantly more than the control group, the observation group patients ＇exhaust time （19.3±5.2） h, was obviously faster than the control group, the observation group hospitalization time was （5.2±1. 1） d, was significantly shorter than the control group, the difference was significant （P〈0.05）. Conclusion Laparoscopic-assisted vaginal hysterectomy with less trauma, rapid postoperative recovery, fewer complications, etc., should be promoted and applied.