腹腔镜与腹式大子宫全切除术的对比分析

目的:比较腹腔镜和腹式大子宫全切除术的手术时间、术中出血量和术后病率,探讨腹腔镜下大子宫切除术的安全性和可行性。方法:回顾分析该院2007年1月～2010年1月大子宫切除术300例的临床资料,其中开腹150例,腹腔镜150例,对比分析两种术式术中、术后各项参数。结果:腹腔镜组手术时间长于开腹组,差异有统计学意义(P<0.05),术中出血量明显少于开腹组,差异有统计学意义(P<0.05),腹腔镜组术后肛门排气时间、术后病率明显低于开腹组,差异有统计学意义(P<0.01)。结论:改良后的腹腔镜下大子宫全切术是安全可行的,该术式微创,对腹腔干扰小,术后病率低。

Comparison and analysis on laparoscopic surgery and laparotomy for total hysterectomy of large uterus

Objective:To compare the operation times,the amounts of blood loss during operation,and postoperative morbidities of laparoscopic surgery and laparotomy for total hysterectomy of large uterus,explore the safety and feasibility of total hysterectomy of large uterus under laparoscope.Methods:The clinical data of 300 cases undergoing total hysterectomy of large uterus in the hospital from January 2007 to January 2010 were analyzed retrospectively,150 cases underwent laparotomy and 150 cases underwent laparoscopic surgery,the intraoperative and postoperative parameters of the two therapeutic methods were compared and analyzed.Results:The operation time in laparoscopic surgery group was significantly longer than that in laparotomy group(P<0.05).The amount of blood loss during operation in laparoscopic surgery group was significantly less than that in laparotomy group(P<0.05).The postoperative exhausting time in laparoscopic surgery group was significantly shorter than that in laparotomy group(P<0.01).The postoperative morbidity in laparoscopic surgery group was significantly lower than that in laparotomy group(P<0.01).Conclusion:Modified total hysterectomy of large uterus under laparoscope is safe and feasible,the method has the advantages of minimal injury,small interfere to abdominal cavity,and low postoperative morbidity.