腹腔镜辅助下阴式全子宫切除术和经阴道非脱垂全子宫切除术的临床比较  

Clinical comparison of laparoscopic assisted transvaginal hysterectomy(LAVH) and transvaginal hysterectomy(TVH)

作　　者：施晓梅[1] 任秀萍[1] 

机构地区：[1]安徽省蚌埠市第一人民医院妇产科,233000

出　　处：《淮海医药》2012年第2期112-114,共3页Journal of Huaihai Medicine

摘　　要：目的比较腹腔镜辅助下阴式全子宫切除术和经阴道非脱垂全子宫切除术的临床效果。方法回顾性分析2010年5月～2011年9月我院妇科行腹腔镜辅助下阴式全子宫切除术组43例(LAVH组),和同期经阴道非脱垂全子宫切除术39例(TVH组)患者的临床资料,比较其基本特征、平均手术时间、术中平均出血量、术后体温恢复时间、术后排气时间、下床活动时间、术后平均住院天数等情况。结果 LAVH组43例均成功,TVH组39例中1例中转开腹。2组平均手术时间比较:子宫小于12孕周时,TVH组明显短于LAVH组(P<0.05),子宫大于15孕周时,TVH组明显长于LAVH组(P<0.05);子宫在13～15孕周时2组手术时间差异无显著性(P>0.05)。术中平均出血量:子宫小于12孕周时,2组无统计学差异(P>0.05);子宫大于12孕周时,LAVH组明显少于TVH组(P<0.05)。术后肛门排气时间、下床活动时间、术后住院时间、术后体温恢复时间2,组差异无统计学意义(P>0.05)。结论 LAVH与TVH均为创伤小、恢复快的微创手术,但TVH适合子宫相对较小,无盆腔粘连者;而LAVH对子宫大,有盆腔粘连或合并附件病变患者更有优势。Objective To compare the efficacy of transvaginal hysterectomy and transabdominal hysterectomy with non-prolapsed uterus（TAH）.Methods Retrospective analysis was conducted as to the clinical data of 43 cases（LAVH group） and 39 cases（TVH group） from May 2010 to September 2011,and their basic characteristics,average operation time,intraoperative blood loss,postoperative temperature recovery time,postoperative exhaust time,time to get out of bed and the average hospital stay were compared.Results All 43 LAVH cases succeeded,while one of the 39 TVH cases converted to laparotomy.Comparison of both operation time：TVH was distinctly shorter than LAVH（P0.05） when the pregnancy period was less than 12 weeks,and longer at 15th pregnancy weeks（P0.05）.Both were almost the same during the 13-15th pregnancy weeks（P0.05）.There was no statistical differences of intraoperative average blood loss between LAVH and HVA when the pregnancy period was less than 12 weeks（P0.05）,but the blood loss in LVAH was obviously less than in TVH when the pregnancy was over 12 weeks（P0.05）.Besides there was no significant difference about postoperative exhaust time,time to get out of bed,the average hospital stay and postoperative temperature recovery time（P0.05）.Conclusion Both LAVH and TVH are micro trauma,tacho-recovery minimally invasive surgery.TVH is suitable for women with relatively small and no pelvic adhesion,but LAVH has more advantages for patients who have big uterus,with pelvic adhesion or associated adnexal diseases.

关 键 词：子宫切除术 腹腔镜手术 阴式手术 

分 类 号：R713.42[医药卫生—妇产科学]