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目的比较腹腔镜辅助阴式子宫切除术(laparoscopically assisted vaginal hysterectomy,LAVH)与腹腔镜全子宫切除术(total laparoscopic hysterectomy,TLH)治疗妇科良性疾病的临床效果。方法妇科良性疾病行腹腔镜子宫全切除术患者1 264例,其中行LAVH术689例为LAVH组,行TLH术575例为TLH组,比较2组术中出血量,手术时间,术中、术后并发症情况,术后抗生素使用时间,肛门排气时间,术后3d体温,疼痛持续时间,住院时间。结果LAVH组手术时间[(82±27)mim]较TLH组[(117±31)min]短,术中出血量[(91±28)mL]较TLH组[(117±31)mL]少,肛门排气时间[(17±6)h]较TLH组[(21±7)h]短,术后3d体温[(37.8±0.6)℃]较TLH组[(37.5±0.4)℃]高,术后疼痛持续时间[(28.0±5.6)h]及住院时间[(4.1±0.4)d]较TLH组[(18.0±4.8)h、(3.9±0.5)d]长(P<0.05);LAVH组抗生素使用时间[(1.7±1.1)d]、手术并发症发生率(0.87%)与TLH组[(1.6±0.9)d、0.70%]比较差异无统计学意义(P>0.05)。结论 LAVH术和TLH术各有优、缺点,临床应根据患者情况综合考虑,选择最佳术式。
Objective To compare the clinical effects of laparoscopically assisted vaginal hysterectomy (LAVH) and total laparoscopic hysterectomy (TLH) in the treatment of benign gynecological diseases. Methods A total of 1 264 cases of gynecological benign diseases underwent laparoscopic total hysterectomy, of which 689 cases underwent LAVH for LAVH group and 575 cases for TLH group as TLH group. The intraoperative blood loss, operative time, Postoperative complications, postoperative antibiotic use time, anal exhaust time, postoperative 3d body temperature, duration of pain, hospital stay. Results The operative time in LAVH group (82 ± 27) mim was shorter than that in TLH group (117 ± 31) min and was (91 ± 28) mL in TLH group (37 ± 0.6) ℃] were significantly shorter than those in TLH group [(21 ± 7) h] and postoperative 3d (37.5 ± 0.4) ℃] , Duration of postoperative pain (28.0 ± 5.6 h) and hospital stay (4.1 ± 0.4) d were longer than those in TLH group (18.0 ± 4.8 h and 3.9 ± 0.5 d, respectively, P <0.05). The antibiotic use time in LAVH group was (1.7 ± 1.1) d, and the incidence of operative complication (0.87%) was not significantly different from that in TLH group (1.6 ± 0.9 d, 0.70%) (P> 0.05). Conclusion LAVH and TLH have their own advantages and disadvantages, clinical should be based on patients with comprehensive consideration, select the best surgical procedures.