腹腔镜全子宫切除术43例临床分析  

Clinical Analyzing on 43 Cases Total Laparoscopic Hysterectomy

作　　者：王雪梅[1] 汪艳[1] 

机构地区：[1]安徽省安庆市立医院妇产科,安徽安庆246003

出　　处：《河北医学》2010年第3期304-307,共4页Hebei Medicine

摘　　要：目的：探讨双极电凝钳、杯状举宫器在腹腔镜全子宫切除术中的技术要点及临床应用价值。方法：2009年1月至2009年7月,使用双极电凝钳、杯状举宫器完成腹腔镜下全子宫切除术43例,包括子宫肌瘤25例,子宫腺肌病8例,功能失调性子宫出血6例,宫颈上皮内瘤变Ⅲ级4例。使用双极电凝钳完成全子宫切除,沿杯状举宫器穹隆杯上缘切开阴道前壁并沿宫颈环形切断阴道壁,完整切除子宫颈。结果：43例均成功完成,无中转开腹手术。手术时间100~195 min,平均120 min。术中出血量50~600 ml,平均150 ml。术中无阴道残端出血及输尿管、膀胱、直肠损伤。术后住院4~8 d,平均6.2d。结论：使用双极电凝钳、杯状举宫器行腹腔镜下全子宫切除术,提高了手术的安全性且操作简捷,有利于腹腔镜子宫切除术的普及推广。Objective： To investigate the clinical value and surgical skill of laparoscopic hysterectomy（TLH） using uterus lifting cup and bipolar-electric coagulation.Method： From January 2009 to July 2009,TLH was performed on 43 patients using uterus lifting cup bipolar-electric coagulation.Among the patients,25 had hysteromyoma,8 had adenomyosis,6 had dysfunctional uterine bleeding,and 4 had grade CIN Ⅲ.After the uterus was resected completely using bipolar-electric coagulation,the anterior wall of vagina was cut circularly along the upper margin of the uterus lifting cup to resect the cervix.Result： TLH was completed in all 43 cases without conversion to open surgery.The operation time ranged from 100 to 195 minutes with a mean of 120 minutes.The mean blood loss was 150ml（50 ~600 ml）.No patient had vaginal stump bleeding or injuries to the ureter,bladder and rectum.The patients were discharged from hospital 4 to 8 days after the operation（mean,6.2 days）.Conclusion： TLH is safe by using uterus lifting cup and bipolar electric coagulation forceps,which makes the procedure more convenient.

关 键 词：腹腔镜 子宫切除术 双极电凝钳 杯状举宫器 

分 类 号：R713.42[医药卫生—妇产科学]