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目的探讨改良腹腔镜筋膜内子宫切除术(MISH)的临床应用价值。方法回顾分析江西省人民医院2005年6月至2010年5月所施行的MISH123例和CISH254例的临床资料。比较两组的手术效果(手术时间、术中出血量、术后肛门排气时间、术后住院时间、并发症、手术后的性激素变化)。结果两组的手术时间、术中出血量、术后肛门排气时间、术后住院时间差异无统计学意义(P>0.05);MISH组术后病率,残鞘出血、感染率明显低于CISH组(P<0.01);MISH组术后6个月外周静脉血中卵泡刺激素(FSH)显著低于CISH组(P<0.01)、雌二醇(E2)显著高于CISH组(P<0.01)。结论 MISH创伤小,恢复快,且能保护卵巢功能,是治疗子宫良性病变的理想术式。
Objective To investigate the clinical value of modified laparoscopic hysterectomy (MISH). Methods A retrospective analysis of Jiangxi Provincial People’s Hospital from June 2005 to May 2010 implementation of MISH123 cases and CISH254 cases of clinical data. The operative effects (operative time, intraoperative blood loss, postoperative anal exhaust time, postoperative hospital stay, complications, postoperative sex hormone changes) were compared between the two groups. Results The operation time, intraoperative blood loss, postoperative anal exhaust time and postoperative hospital stay had no significant difference (P> 0.05). The postoperative morbidity, residual hemorrhage and infection rate in MISH group were significantly lower than those in MISH group (P <0.01). The follicle stimulating hormone (FSH) in peripheral blood of MISH group was significantly lower than that of CISH group (P <0.01) and estradiol (E2) of CISH group (P < 0.01). Conclusion MISH is less invasive, faster recovery, and can protect ovarian function, which is the ideal surgical treatment of benign uterine lesions.