腹腔镜辅助阴式子宫切除术与经腹子宫切除术的前瞻性随机对照研究  

A prospective randomized study of laparoscopically assisted vaginal hysterectomy versus abdominal hysterectomy

作　　者：张萍[1] 凌奋[1] 曾嫣[1] 

机构地区：[1]上海第二医科大学附属新华医院妇产科,200092

出　　处：《上海医学》2004年第10期736-738,共3页Shanghai Medical Journal

摘　　要：目的　比较评估腹腔镜辅助阴道子宫切除术与经腹子宫切除术两种手术的临床效果。方法　 12 0例妇科良性疾病患者需行子宫切除术 ,但有经阴道子宫切除术的相对禁忌证、子宫不超过孕 16周 ,随机分成两组 ,甲组 (6 0例 )行腹腔镜辅助阴式子宫切除术 ,乙组 (6 0例 )行经腹子宫切除术。结果　两组患者年龄、产次、术前血红蛋白水平、子宫平均重量、术中失血、手术时间的差异无显著性 (P >0 .0 5 )。甲组术后疼痛程度、术后住院时间明显少于乙组 (P <0 .0 1) ,两组均未出现严重手术并发症。结论　腹腔镜辅助阴式子宫切除术具有创伤小、恢复快、住院时间短等优点 ,妇科医师经过良好的腹腔镜手术操作技能培训 ,能对大部分原不宜行阴式子宫切除术而需行经腹子宫切除术的患者行腹腔镜辅助阴式子宫切除术。Objective To evaluate the efficacy of laparoscopically assisted vaginal hy sterectomy with that of abdominal hysterectomy.Methods One hundred and twenty patients suffered from benign gynecological diseases referred for abdominal hys terectomy were randomily alloeated into two groups, laparoscopically assisted va ginal hy sterectomy and abdominal hysterectomy, 60 patients for each. The upper limit of uterine size was set at 16 weeks gestation. Results There were no differences in terms of patients age, parity, preoperative hemoglo bin levels, mean uterine weight, blood losses, operating duration between the tw o g roups(P>0.05). Postoperative pain and postoperative hospitalized period wer e significantly less by laparoscopically assisted vaginal hysterectomy than by a bdominal hysterectomy(P<0.01). There were no severe complications in the two groups.Conclusion Laparoscopically assisted vaginal hysterectomy gives less damage,and quicker rec overy, and may replace the abdominal hysterectomy whenever there is contraind ication for the latter.

关 键 词：前瞻性随机对照研究 子宫切除术 腹腔镜 剖腹术 腹腔镜辅助阴道子宫切除术 

分 类 号：R713.4[医药卫生—妇产科学]