论文部分内容阅读
目的:比较改良腹腔镜大子宫切除术(TLH)与改良腹腔镜辅助阴式大子宫切除术(LAVH)的临床效果。方法:回顾分析2007年1月~2012年12月我院收治的127例大子宫(子宫大小≥孕12周)切除术患者的临床资料,其中改良TLH组65例,改良LAVH组62例。比较两组的手术时间、术中出血量、子宫重量、术后排气时间、术后住院时间及围术期并发症的发生率。结果:127例患者手术均能顺利完成,改良TLH组2例术中转LAVH完成,无一例中转开腹。改良TLH组的手术时间[(116.0±30.4)min]、出血量[(98.3±45.8)ml]均显著低于改良LAVH组[(147.0±40.4)min,(133±41.7)ml](P<0.05)。两组的子宫重量、术后排气时间、术后住院时间及围术期并发症发生率均无显著差异(P>0.05)。结论:两种术式均为微创、安全、有效,改良TLH比改良LAVH手术时间短,出血少。应综合考虑患者的具体情况、术者手术经验和技术及手术设备和器械因素选择安全、有效术式。
Objective: To compare the clinical effects of modified laparoscopic hysterectomy (TLH) with modified laparoscopic assisted vaginal hysterectomy (LAVH). Methods: The clinical data of 127 cases of large uterus (uterine size ≥ 12 weeks) resection in our hospital from January 2007 to December 2012 were analyzed retrospectively. Among them, 65 cases were modified TLH group and 62 cases were improved LAVH group. The operation time, intraoperative blood loss, uterine weight, postoperative exhaust time, postoperative hospital stay and perioperative complications were compared between the two groups. Results: The operation of 127 patients was successfully completed. Two cases of modified TLH group were treated with LAVH, and none of them was converted to laparotomy. The operative time of the modified TLH group was (116.0 ± 30.4) min and the amount of bleeding (98.3 ± 45.8) ml were significantly lower than that of the modified LAVH group (147.0 ± 40.4 min vs 133 ± 41.7 ml, P < 0.05). Uterine weight, postoperative exhaust time, postoperative hospital stay and perioperative complications were not significantly different between the two groups (P> 0.05). Conclusion: The two surgical procedures are minimally invasive, safe and effective. The modified TLH has shorter operative time and less bleeding than modified LAVH. Patients should consider the specific circumstances, surgical experience and technical and surgical equipment and equipment factors to choose a safe and effective surgical procedures.