腹腔镜辅助下阴式子宫全切术治疗子宫良性病变的临床效果评价  

Clinical evaluation of laparoscopic assisted vaginal hysterectomy for benign uterine lesions

作　　者：戚田进 孙彦玲 QI Tian-jin;SUN Yan-ling(Department of Obstetrics and Gynecology,First People's Hospital of Chuzhou,Chuzhou Anhui 239000,P.R.China;Department of Obstetrics and Gynecology,Wuxi Huishan District People's Hospital,Wuxi Jiangsu 214187,P.R.China)

机构地区：[1]滁州市第一人民医院妇产科,安徽滁州239000 [2]无锡市惠山区人民医院妇产科,江苏无锡214187

出　　处：《中国计划生育和妇产科》2019年第2期81-84,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：无锡市卫计委妇幼健康适宜技术推广项目(项目编号:FYTG 201605)

摘　　要：目的探究腹腔镜辅助下阴式手术方案治疗子宫良性病变患者的临床疗效。方法回顾性分析滁州市第一人民医院妇产科于2015年3月至2017年2月收治的94例子宫良性病变患者的临床资料,根据手术方式不同分为研究组和对照组,各47例。对照组行传统开腹子宫全切术,研究组行腹腔镜辅助下阴式子宫全切术(laparoscopically assisted vaginal hysterectomsy,LAVH)。比较两组患者手术基本情况、术后并发症发生率及不同时间点的白细胞介素(interleukin,IL)-2、IL-4值。结果研究组和对照组手术时间[(104. 9±8. 6) minvs (97. 5±7. 1) min]比较,差异无统计学意义(P> 0. 05);研究组与对照组的术中出血量[(147. 3±12. 9) m Lvs (204. 7±17. 5) m L]、肛门排气时间[(23. 7±5. 2) h vs (41. 4±8. 3) h]、住院时间[(5. 8±1. 1) d vs(10. 3±2. 4) d]、术后首次下床活动时间[(33. 6±4. 2) h vs(42. 8±6. 7) h]、术后不良事件发生率(4. 2%vs 10. 6%)明显低于对照组,差异均有统计学意义(P <0. 05)。两组患者术前1 d的IL-2、IL-4值差异均无统计学意义(P> 0. 05);术后1 d及术后5 d,研究组IL-2值[(40. 8±6. 2) ng/L、(48. 7±4. 5) ng/L]高于对照组[(21. 2±6. 4) ng/L、(29. 6±1. 8) ng/L](P <0. 05),而IL-4值[(44. 8±7. 0) ng/L、(43. 5±3. 6) ng/L]低于对照组[(65. 7±12. 4) ng/L、(61. 3±11. 5) ng/L](P <0. 05)。研究组术后病率(6. 4%)低于对照组(23. 4%)(P <0. 05)。结论 LAVH是一项相对安全、高效的治疗方案,与传统手术方案相比,能减小机体切口创面,并降低创伤对人体的免疫抑制作用,有较好的临床疗效。Objective To explore the clinical efficacy of laparoscopic-assisted vaginal surgery for patients with benign uterine lesions.Methods Retrospective analysis of the clinical data of 94 patients with benign uterine diseases admitted to First People ’s Hospital of Chuzhou from March 2015 to February 2017.According to different surgical methods,they were divided into study group and control group,with 47 cases in each group.The patients in control group underwent conventional open hysterectomy and the study group underwent laparoscopically assisted vaginal hysterectomy(LAVH).The basic conditions of surgery,the incidence of postoperative complications and the levels of interleukin(IL)-2 and IL-4 at different time points were compared between the two groups.Results There was no significant difference in the operation time between the study group and the control group [(104.9±8.6) min vs(97.5±7.1) min) ](P>0.05).The intraoperative blood loss in the study group was less than that in the control group [(147.3 ±12.9) m L vs(204.7±17.5) m L](P<0.05);Anal exhaust time[(23.7±5.2) h vs(41.4±8.3) h],hospital stay [(5.8 ±1.1) d vs(10.3±2.4) d],time to first get out of bed after surgery [(33.6±4.2) h vs(42.8±6.7) h] were shorter than the control group(P<0.05).The incidence of postoperative adverse events was 4.2 % in the study group,which was significantly lower than that in the control group(10.6 %).The difference was statistically significant(P<0.05).There were no significant difference in IL-2 and IL-4 between the two groups(P>0.05).The IL-2 value of the study group was 1 day and 5 days after surgery[(40.8±6.2) ng/L,(48.7±4.5) ng/L]were higher than the control group [(21.2±6.4) ng/L,(29.6±1.8) ng/L](P<0.05),while the IL-4 value was lower than the control group(P<0.05).The postoperative morbidity rate of the study group(6.4 %) was lower than that of the control group(23.4 %),and the difference was statistically significant(P<0.05).Conclusion LAVH is a relatively safe and effective treatment plan.Compared with tra

关 键 词：子宫良性病变 腹腔镜辅助下阴式子宫全切术 免疫抑制 病情预后 

分 类 号：R713.42[医药卫生—妇产科学]