经阴式与腹腔镜子宫全切术对非脱垂子宫良性病变患者临床疗效、疼痛、并发症及术后生活质量的影响对比  

Effects of Laparoscopic and Transvaginal Hysterectomy on the Clinical Efficacy,Pain,Complications and Quality of Life of Patients with Non-Prolapsed Benign Uterine Lesions

作　　者：张惠 Zhang Hui(Department of Obstetrics and Gynecology,Yucheng people's Hospital,Ya'an City 625000,China)

机构地区：[1]雅安市雨城区人民医院妇产科,雅安625000

出　　处：《四川解剖学杂志》2020年第4期5-7,24,共4页Sichuan Journal of Anatomy

基　　金：雨城区重点科技计划项目(非脱垂子宫阴式切除术的临床研究)

摘　　要：目的分析腹腔镜与经阴式切除子宫两种术式治疗对非脱垂子宫良性病变患者临床疗效、疼痛、并发症及术后生活质量的影响。方法选取2018年1月~2019年1月本院收治的50例需行子宫切除术的非脱垂子宫良性病变患者作为研究对象,按照治疗方式的差异分为腹腔镜组(n=26)及阴式组(n=24)。阴式组患者行阴式子宫全切术,腹腔镜组患者行腹腔镜子宫全切术。比较两组患者手术指标、术后盆底功能、生活质量及并发症(断蒂出血、膀胱损伤、阴道残端感染、阴道残端出血、腹腔积血、血尿、宫颈血肿及附件粘连等)发生情况。结果阴式组患者手术时间、术后肛门排气时间均明显短于腹腔镜组,术中出血量明显高于腹腔镜组,住院总费用较腹腔镜组少(P<0.05);两组患者阴道顶端脱垂及压力性尿失禁发生情况比较无差异(P>0.05);术后6个月阴式组EORTC QLQC30评分中各项功能评分均高于腹腔镜组(P<0.05);腹腔镜组并发症发生率为(7.69%),明显低于阴式组(29.17%)(P<0.05)。结论腹腔镜与经阴式子宫全切术治疗非脱垂子宫良性病变均有显著疗效,腹腔镜子宫切除术对患者生活质量的影响小,但阴式子宫切除术简单经济,适合基层医院实施,临床可根据患者情况合理选择术式。Objective This study aimed to analyze the effects of laparoscopic and transvaginal hysterectomy on the clinical efficacy,pain,complications and quality of life of patients with non-pro lapsed benign uterine lesions.Methods Fifty patients with benign non-prolapsed uterine lesions requiring hysterectomy who were admitted to our hospital from January 2018 to January 2019 were selected and divided into laparoscopic group(n=26)and transvaginal group(n=24)according to the difference in treatment methods.Patients in the transvaginal group underwent transvaginal hysterectomy,and patients in the laparoscopic group underwent total laparoscopic hysterectomy.We compared the operation time,intraoperative blood loss,anal exhaust time,postoperative hospital stay and total cost of treatment,postoperative pelvic floor function,quality of life and complications(bleeding of broken pedicle,bladder injury,infection of vaginal stump,bleeding of the vaginal stump,hematocelia,hematuria,cervical hematoma and attachment adhesion,etc.)in the two groups.Results The operation time of the transvaginal group was shorter than that of the laparoscopic group.The postoperative anal exhaust time and the intraoperative blood loss were higher than those of the laparoscopic group.The total cost of hospitalization was less than that of the laparoscopic group(P<0.05).There was no difference in the incidence of prolapse of vaginal tip and stress incontinence between the two groups(P>0.05).All functional scores in the EORTC QLQ-C30 score in the transvaginal group 6 months after surgery were higher than those in the laparoscopic group(P<0.05).The incidence of complications in the laparoscopic group(7.69%)was lower than that in the transvaginal group(29.17%)(P<0.05).Conclusion Both laparoscopic and transvaginal hysterectomy have significant effects in the treatment of non-prolapsed uterine benign lesions.Laparoscopic hysterectomy has better curative effects on the quality of life of patients than transvaginal hysterectomy,but transvaginal hysterectomy is si

关 键 词：非脱垂 良性子宫病变 阴式全子宫切除术 腹腔镜 生存质量 

分 类 号：R713.42[医药卫生—妇产科学]