腹腔镜子宫切除术与经腹子宫切除术效果比较

目的 比较经腹子宫切除术（TAH）与腹腔镜子宫切除术（LAVH）临床效果及安全性.方法 400例良性子宫病变需行子宫切除术患者,在患者知情同意下,按子宫切除术方式的不同分为TAH组（202例）及LAVH组（198例）,观察两种手术术式的l临床效果及并发症发生情况.结果 TAH组平均手术时间显著短于LAVH组（t=20.84,P＜0.05）,LAVH组术中出血量及置引流病例均较TAH组减少（t=21.19,x2=6.24,均P＜0.05）;TAH组术后肛门排气时间、平均住院日明显高于LAVH组（t=32.75、8.31,均P＜0.05）,LAVH组平均医疗费用明显高于TAH组（t=6.13,P＜0.05）.术后1、3、6个月门诊随诊,常规行B超及妇科检查,两组临床症状术后全部缓解,LAVH组平均康复时间（即手术至恢复工作时间）（21 ±7）d与TAH组的（36±8）d比较,两组差异有统计学意义（t=19.69,P＜0.05）,两组B超随访均未发现明显肌瘤结节.结论 两种子宫切除术各有利弊及适应证,选择手术方式时应根据患者的具体情况.

The clinical analysis of transvaginal abdominal hysterectomy and laparoscopically assisted vaginal hysterectomy

Objective To evaluate and compare the advantages and disadvantages and the clinical application between transvaginal abdominal hysterectomy(TAH)and laparoscopically assisted vaginal hysterectomy(LAVH)on the benign lesions of non-prolapsed uterus.Methods 400 patients with benign lesions of non-prolapsed uterus were divided into two groups,TAH group(202 cases)and LAVH group(198 cases).The effects of clinical treatment of the two groups were compared.Results There were significant differentces between the two groups in operation time,the blood loss,passage of gas by anus,return to normal activities,and overall cost of treatment.However,after 1to 3 months follow-up,all patients were good in terms of outcome.Conclusion Different surgical patterns of hysterectomy had their distinctive advantages.The key point of a successful operation Was to avoid complications of the operation.