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目的探讨改良腹腔镜较大子宫切除术(total laparoscopic hysterectomy,TLH)治疗较大子宫肌瘤(或子宫腺肌病,子宫≥16孕周)的临床效果。方法收集2007年3月~2013年4月较大子宫肌瘤(或子宫腺肌病,子宫≥16孕周)在我院行大子宫切除术183例患者的临床资料,其中传统TLH 88例(对照组),改良TLH 95例(研究组),比较两组手术时间、术中出血量、肛门排气时间。结果所有手术均顺利完成,近期随访均无严重并发症发生。研究组与对照组相比,手术时间无明显差异(P>0.05),术中出血量明显减少(P<0.05),肛门排气时间短(P<0.05)。结论改良TLH降低了腹腔镜较大子宫切除术的难度,术中出血少,是一种值得推广的微创手术。
Objective To investigate the clinical effect of modified laparoscopic total laparoscopic hysterectomy (TLH) for the treatment of larger uterine fibroids (or adenomyosis, uterus ≥ 16 gestational weeks). Methods The clinical data of 183 patients with large uterine fibroids (or adenomyosis, uterus ≥ 16 gestational weeks) undergoing hysterectomy in our hospital from March 2007 to April 2013 were collected. 88 cases of TLH Control group). 95 cases of TLH were improved (study group). The operation time, intraoperative blood loss and anal exhaust time were compared between the two groups. Results All the operations were successfully completed. No serious complications occurred in the recent follow-up. Compared with the control group, there was no significant difference in the operation time between the study group and the control group (P> 0.05). The blood loss in the study group was significantly decreased (P <0.05) and the time of anal exhaust was shorter (P <0.05). Conclusion Improved TLH reduces the difficulty of laparoscopic hysterectomy, less bleeding, is a worthy of promotion of minimally invasive surgery.