腹腔镜辅助与腹腔镜全子宫切除术的对比研究

目的:对比分析腹腔镜辅助阴式全子宫切除术(laparoscopically assisted vaginal hysterectomy,LAVH)与腹腔镜全子宫切除术(total laparoscopic hysterectomy,TLH)的临床疗效。方法:将101例子宫肌瘤、腺肌症患者随机分为两组,其中60例行LAVH(LAVH组),41例行TLH(TLH组),对比分析两组患者术中情况、术后并发症及性生活恢复等指标。结果:TLH组中有腹部手术史的患者多于LAVH组,手术时间较长(P<0.05);住院费用、住院时间、并发症发生率两组相比差异无统计学意义(P>0.05)。术后性生活方面,LAVH组性交困难人数显著减少,两组患者术后性生活的协调性显著增加(P<0.05)。结论:LAVH较TLH手术时间更短,术后性功能恢复优于TLH,但出血量、住院时间及术后并发症差异无统计学意义;对于不能耐受长时间手术的患者而言,LAVH是安全、有效的术式。

Comparative study between laparoscopically assisted vaginal hysterectomy and totally laparoscopic hysterectomy

Objective ：To compare the clinical effect between laparoscopically assisted vaginal hysterectomy （LAVH） and total laparoscopic hysterectomy （TLH）. Methods：Patients （n = 101 ） with uterine fibroids or adenomyosis were randomly divided into 2 groups ： LAVH group （ n = 60 ） and TLH group （ n = 41 ）. The intraoperative conditions, postoperative complications and recovery of sexual life were comparatively analyzed. Results：With similar general characteristics, TLH group had more patients with abdominal surgery history and required longer surgery duration than LAVH group. There were no significant differences between the two groups in hospitalization cost, hospital stay and rate of various complications （P 〉 0.05 ）. As for sexual function, dyspareunia in LAVH group decreased significantly in postoperative follow-up （ P 〈 0.05 ）. Sexual harmony significantly increased in both groups （ P 〈 0.05 ）. Conclusions ： LAVH has the advantages over TLH in shorter surgery duration and sexual function recovery, though blood loss, hospital stay and complications were similar in LAVH and TLH. LAVH could be effectively and safely performed for surgery duration time limited patients.