腹腔镜膀胱侧入层次分离法行大子宫全切除术的效果分析  

Hysterectomy for large uterus by bladder side and anatomical level separation method

作　　者：卢杰平[1] 耿丹[1] 韩晓凤[1] 刘长丽[1] 赵福杰[2] 

机构地区：[1]辽宁省沈阳市苏家屯区妇婴医院妇产科,辽宁沈阳110101 [2]中国医科大学附属盛京医院妇产科,辽宁沈阳110004

出　　处：《中国内镜杂志》2015年第10期1085-1089,共5页China Journal of Endoscopy

摘　　要：目的探讨腹腔镜下经膀胱侧入、层次分离法行大子宫全切除术的可行性和优越性。方法以大子宫、多发性子宫肌瘤入院,无生育要求、无手术禁忌证患者22例作为观察组,采用膀胱侧入、层次分离法行腹腔镜下全子宫切除术治疗。取常规法腹腔镜全子宫切除术患者,21例作为对照组,其病例入选条件和肿瘤类型与观察组相似。分析比较两组间的术中和术后情况。结果观察组的手术时间、术中出血量、离床活动时间和住院天数均明显少于对照组,差异有统计学意义(P<0.01)。术后体温和排气时间两组差异无统计学意义(P>0.05)。对照组有1例膀胱轻度副损伤转开腹手术,有2例术后有慢性腹痛症状。结论膀胱侧入、层次分离法腹腔镜下全子宫切除术治疗大子宫、多发性子宫肌瘤临床疗效好、安全可行,较常规法腹腔镜全子宫切除术具有泌尿系统损伤率降低、手术时间短、术中出血量少、离床活动时间短、住院天数少,术后恢复快的优点。【Objective】To discuss the advantage and the feasibility of total laparoscopic hysterectomy treatment for large uterus or multiple myoma of uterus by bladder side and anatomical level separation method. 【Methods】The observation group： 22 patients with large uterus or multiple myoma of uterus and no fertility requirements, no malignant transformation and operation contraindication were collected in the treatment of total laparoscopic hysterectomy by bladder side, anatomical level separation method. The control group： A retrospective analysis with the treatment of conventional Total Laparoscopic Hysterectomy, a total of 21 patients as control, the cases selected conditions is similar with the observation group. Some indexes during and after operation were recorded.【Results】The observation group in the operation time, bleeding volume, off bed activity time and hospital stay were significantly less than the control group, the difference was statistically significant（P〈0.01）. There were no significant differences between the two groups in the postoperative body temperature and exhaust time（P〉0.05）. There was 1 case because the bladder mild injury into open abdominal operation treatment and 2 cases with 1postoperative chronic abdominal pain in the control group. 【Conclusion】The Total Laparoscopic Hysterectomy treatment for large uterus or multiple myoma of uterus by bladder side, anatomical level separation method is safe and feasible, compared with conventional method of hysterectomy has advantages of short operation time, less bleeding volume, and duration from the bed and less hospitalization time and faster postoperative recovery.

关 键 词：大子宫 多发性子宫肌瘤 膀胱侧入、层次分离法 腹腔镜全子宫切除术 

分 类 号：R713[医药卫生—妇产科学]