腹腔镜辅助子宫全切术390例临床分析  

Analysis of 390 Patients wtih Laparoscopic Assisted Vaginal Hysterectomy

作　　者：龙雯晴[1] 喇端端[1] 沈立翡[1] 唐中园[1] 沈育红[1] 

机构地区：[1]上海交通大学医学院瑞金医院妇产科上海微创外科医学中心,上海200025

出　　处：《上海交通大学学报（医学版）》2006年第12期1381-1383,共3页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的探讨腹腔镜辅助子宫切除术（LAVH）在妇科领域的临床应用价值。方法对该院自2003年5月～2005年4月在腹腔镜下行全子宫切除术的390例患者的资料进行回顾性分析。患者平均年龄（49．9＋1）岁。手术指征：子宫肌瘤256例、子宫腺肌病41例、子宫肌瘤合并子宫腺肌瘤31例、子宫异常出血33例、子宫内膜不典型增生9例、子宫内膜异位囊肿盆腔内异症13例、宫颈上皮内瘤变（CIN）Ⅲ级5例、严重原发性血小板减少性紫癜（ITP）2例。结果390例患者中11例因盆腔严重粘连、子宫活动受限而中转开腹，平均手术时间70．2min（40～160min），术中平均出血量183．5mL（50～800mL），术后平均住院6d。手术并发症14例，占3．6％，经治疗后均无严重后遗症。结论LAVH扩大了子宫切除的手术可选择范围，是一种安全、有效、有推广价值的子宫切除方式。Objective To discuss the application value of laparoscopic assisted vaginal hysterectomy （ LAVH ） in clinical gynecology. Methods The data of 390 patients who were performed LAVH from May 2003 to April 2005 were reviewed and analyzed. The average age was （ 49.9 ＋ 1 ） years. Operation indications ： uterine myoma （ n = 256） , adenomyoma （ n = 41 ） , adenomyoma complicated with hysteromyoma （ n = 31 ） , abnormal uterine bleeding （ n =33 ） , atypical hyperplasia of endometrium（ n =9 ） , pelvic endometriosis （ n = 13 ） , CIN Ⅲ （ n = 5 ） and severe ITP （ n = 2）. Results Eleven patients converted to open operation due to pelvic adhesions and limitation of uterine motion. The average operation time, bleeding, and hospitalization were 70.2 min（40 -160 min）, 183.5 mL （50 - 800 mL） , and 6 days, respectively. There were about 14 （3.6%） cases of complications and no sequela was observed after treatment. Conclusion LAVH can expand the operation scope, and is a safe, effective and valuable modus operandi.

关 键 词：腹腔镜 子宫切除术 手术指征 

分 类 号：R713.42[医药卫生—妇产科学]