腹腔镜全子宫切除与开腹全子宫切除术的并发症比较  

Comparison of Complications after Total Laparoscopic Hysterectomy and Total Abdominal Hysterectomy

作　　者：徐平[1] 王丹霞[1] 谭玉珠[1] 蓝爱琴[1] 

机构地区：[1]广西壮族自治区北海市人民医院妇科,北海536000

出　　处：《中国微创外科杂志》2010年第3期223-224,229,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的比较腹腔镜全子宫切除术（total laparoscopic hysterectomy,TLH）与开腹全子宫切除术（total abdominal hysterectomy,TAH）的手术并发症。方法回顾性分析我院2004年7月-2008年12月379例TLH与187例TAH的临床资料,比较两者手术并发症。结果除有盆腔手术史者比例TAH组较高外,两种术式患者术前基本特征一致,总的并发症发生率差异无显著性[11.6%（44/379）vs9.6%（18/187）,χ^2=0.505,P=0.477],但TLH组出现2例术后大出血而再次开腹手术,并且阴道残端炎发生率显著高于TAH组[7.1%（27/379）vs2.7%（5/187）,χ^2=4.649,P=0.031];在TAH组,发生腹部切口感染8例,下肢静脉血栓2例,而TLH组无此并发症发生。结论两种手术方式各有优势,虽然总的并发症率无显著性差异,但对于盆腔粘连严重、大子宫肌瘤、特殊部位肌瘤,选择TAH较为安全。Objective To compare the rates of postoperative complications between total laparoscopic hysterectomy（TLH）and total abdominal hysterectomy（TAH）.Methods The clinical data of 379 cases of TLH and 187 cases of TAH,who were treated between July 2004 and December 2008,were analyzed retrospectively.The morbidity rates of the post-operative complications were compared between the two groups.Results Except for the pervious pelvic operation history,there were no significant difference between the two groups in the clinical preoperative characteristics and total morbidities of postoperative complications[11.6%（44/379）vs 9.6%（18/187）,χ^2=0.505,P=0.477].In TLH group,postoperative massive hemorrhage occurred in two cases,in which second laparotomy was then carried out;whereas,in TAH group,eight patients developed incisional infection and two patients had venous thrombosis in the lower limbs.TLH group showed significantly higher rate of vaginal wound infection than TAH group[7.1%（27/379）vs 2.7%（5/187）,χ^2=4.649,P=0.031].Conclusions Although there is not significant difference between TLH and TAH in the total rates of postoperative complications.In certain conditions,including severe pelvic adhesion,huge myoma,and myoma in specific positions,TAH is safer than TLH.

关 键 词：腹腔镜全子宫切除术 开腹全子宫切除术 并发症 

分 类 号：R713.420.6[医药卫生—妇产科学]