阴式子宫全切与腹式子宫全切的临床疗效比较  

The clinical efficacy comparation of transvaginal hysterectomy and transabdominal hysterectomy

作　　者：郭纯[1] 徐景杰[1] 赵玮[1] 

机构地区：[1]武警内蒙古总队医院,内蒙古呼和浩特010040

出　　处：《武警后勤学院学报（医学版）》2012年第12期980-983,共4页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】探比较阴式全子宫切除(transvaginal hysterectomy,TVH)与开腹全子宫切除(transabdominal hysterectomy,TAH)的临床疗效。【方法】回顾分析本院良性子宫病变患者140例,采用以上两种术式行子宫切除术,对于两种术式的手术时间、术中出血量、术后体温升高时间、术后排气时间、术后镇痛率、术后住院日、术后并发症以及测定两组术前、后皮质醇水平、术前、后1d血白细胞计数、中性粒细胞百分比等指标进行比较。【结果】TVH组手术时间、术中出血、术后病率、术后排气时间、术后最高体温、术后住院时间均小于TAH组(P<0.05)。术后镇痛使用率TAH组高于TVH组(P<0.05)。TAH组术后白细胞、中性粒细胞较术前明显升高(P<0.05),TVH组较术前升高不明显。两种术式术后皮质醇水平均升高,而TAH组较TVH组升高明显(P<0.05)。【结论】TVH具有不开腹、腹壁无瘢痕、术后恢复快、并发症少、住院时间短、损伤小、应激反应轻等微创手术的特点,在进行微创手术技术发展的今天,经阴式子宫切除术具有广阔的应用前景,是一种值得推广的手术方式。关键词:阴式子宫切除术;腹式子宫切除术;[Objective]To compare transvaginal hysterectomy（TVH） with transabdominal hysterectomy（TAH） clinical efficacy. [Methods]A retrospective analysis of hospital patients with benign uterine disease 140 cases, using two surgical uterine resection, comparing the indexes of two surgical method,including operative time, blood loss, postoperative temperature rise time, postoperative length of stay, exhaust time after surgery,postoperative complications and postoperative analgesia rate and determination of the patients in two group 1d after white blood cell count, neutrophil percentage, cortisol levels and other indicators to compare. [Results]The operative time, blood loss, postoperative morbidity, postoperative passage of flatus, the highest temperature after surgery, postoperative hospital stay in TVH group were less than TAH group, with statistical significance. Postoperative analgesic usage TAH group was higher than the TVH group. WBC and neutrophils in TAH group was significantly increased compared with the preoperative ,and in TVH group compared with the preoperative elevated notobvious. Two surgical postoperative cortisol levels were elevated, the TAH group increased significantly over the TVH group. [Conclusions]The two approaches are hysterectomy effective approach, TVH has the minimally invasive surgery characteristics, such as not open, no abdominal scar, rapid postoperative recovery, fewer complications, shorter hospital stay, light injury, and light stress response and so on. During the time of the development of minimally invasive surgical techniques, TVH has broad application prospects,it is a surgical approach should be promoted.

关 键 词：阴式子宫切除术 腹式子宫切除术 疗效比较 

分 类 号：R749[医药卫生—神经病学与精神病学]