腹腔镜子宫切除不同术式的临床观察  

Clinical observation of different operation methods of laparoscopic hysterectomy

作　　者：佐满珍[1] 陶静[1] 李伟[1] 杨慧琼[1] 汪琼[1] 陈爱华[1] 王艳[1] 

机构地区：[1]湖北省宜昌市第一人民医院妇产科,湖北宜昌430121

出　　处：《中国内镜杂志》2009年第3期242-245,共4页China Journal of Endoscopy

摘　　要：目的探讨腹腔镜子宫切除术4种术式的适应症及临床效果。方法对168例腹腔镜子宫切除术进行回顾性分析,其中,腹腔镜次全子宫切除术(LSH)33例,腹腔镜鞘膜内子宫切除术(CISH)31例,腹腔镜辅助阴式子宫切除术(LAVH)92例,腹腔镜全子宫切除术(TLH)12例,比较4种子宫切除术式的手术时间,出血量,术后恢复的情况。结果保留宫颈的2种术式手术时间明显多于去除宫颈的2种术式;与粉碎瘤体,及残端渗血止血费时有关;术中出血量以LSH组最多,依次为CISH、LAVH及LTH组,各组间比较差异均有显著性;术后恢复4种术式均良好。结论腹腔镜子宫切除术4种术式都有微创和恢复快特点,且安全可行,手术方式应根据患者的具体情况综合分析恰当选择。[Objective] To investigate the clinical effect and indication of 4 different operation methods of laparoseopic hysterectomy. [Methods] The clinical data of 168 cases of laparoscopic hysterectomy were retrospectively reviewed, including 33 cases of laparoscopic subtotal hysterectomy （LSH）, 31 eases of classic intrafascial supracervical hysterectomy （CISH）, 92 cases of laparoscopic assisted vaginal hysterectomy （LAVH）, and 12 cases of total laparoscopic hysterectomy （TLH）. The time of operation, the blood loss during operation and postoperative recovery, the follow-up after operation in the four groups were compared. [Results] About the time of operation, the two months of remaining cervix were significantly longer than the two methods of removing cervix. It was concerned with crush to pieces of tumor and stop bleeding of stump cervix. The blood loss was significantly different in four groups, the longest in group LSH, in group CISH, LAVH, LTH by turns. Patients in the four groups were all recovered well. [Conclusion] The four methods of laparoscopic hysterectomy have the characteristics of minimally invasive surgery and fast recovery. They are all safe and reliable. Suitable method should be determined according of each patient＇s condition.

关 键 词：腹腔镜 子宫切除术 

分 类 号：R713.4[医药卫生—妇产科学]