3种子宫切除术的临床效果比较  

Comparison of clinical efficacies of three different methods of hysterectomy

作　　者：李杰[1] 

机构地区：[1]安徽省立友谊医院妇产科,安徽合肥230011

出　　处：《中国妇幼保健》2011年第25期3873-3875,共3页Maternal and Child Health Care of China

摘　　要：目的:比较腹式子宫切除术(TAH)、阴式子宫切除术(TVH)与腹腔镜辅助下阴式子宫切除术(LAVH)的不同手术适应证及效果,探讨3种子宫切除术式的最佳选择。方法:回顾性分析安徽省立友谊医院2005年9月～2007年12月及也门哈德拉毛大学附属木卡拉医院2008年1月～12月接受上述3种不同术式子宫切除术病例62例,比较3种手术在手术时间、术中出血量、术后肛门排气时间、术后下床活动时间、术后住院日、术中术后并发症及3者的手术适应证(尤其是子宫大小、盆腔粘连等)。结果:3组平均手术时间、术中平均出血量无统计学差异(P>0.05);TVH组及LAVH组在术后肛门排气时间、术后下床活动时间、术后住院天数、术后疼痛及体温方面与TAH组比较差异有统计学意义(P<0.05)。结论:TVH与LAVH为创伤小、恢复快的微创手术,但TVH适应于子宫小、无粘连并伴下垂者,而LAVH扩大了TVH的适应证,拓宽了阴式手术的选择范围。Objective： To compare the surgical indications and efficacies of transabdominal hysterectomy （TAH）, transvaginal hysterectomy （TVH） and laparoscopically assisted vaginal hysterectomy （LAVH）, explore the optimal method of hysterectomy. Methods： 62 cases receiving the above - mentioned three hysterectomies in the hospital from September 2005 to December 2007 and Mukalla hospital affiliated to Hadramout university from January to December in 2008 were analyzed retrospectively. The operation times, the amounts of blood loss during operation, the postoperative anal exhaust times, the postoperative times of leaving beds, the postoperative hospitalization times, intraoperative and postoperative complications and the surgical indications （ especially the uterine size and pelvic adhesion） in the three groups were compared. Results： There was no significant difference in the average operation time and the amount of blood loss during operation among the three groups （ P 〉 0. 05 ） . There was significant difference in the postoperative anal exhaust time, the postoperative time of leaving beds, the postoperative hospitalization time, postoperative pain and temperature between TVH group, LAVH group and TAH group （ P 〈 0.05 ） . Conclusion ： TVH and LAVH are minimal invasive operation, but TVH is suitable for the cases with small uterus, non - adhesion combined with hysteroptosis ; LAVH expands the indications of TVH and broadens the selective area of transvaginal surgery.

关 键 词：阴式子宫切除术 腹腔镜辅助阴式子宫切除术 腹式子宫切除术 

分 类 号：R713.44[医药卫生—妇产科学]