LigaSure与双极电刀在腹腔镜巨大子宫切除术中的联合应用  

Liga Sure combined with bipolar electric knife in laparoscopic hysterectomy for enormous uterus

作　　者：李卫民[1] 王芳[1] 王艳明[1] 尉艳芹[1] 高凤霞[1] 张晓颖[1] 刘理达 

机构地区：[1]首都医科大学平谷教学医院,北京101200

出　　处：《腹腔镜外科杂志》2015年第12期896-898,共3页Journal of Laparoscopic Surgery

基　　金：首都十大疾病科技成果推广项目;北京市平谷区优秀人才项目资助

摘　　要：目的:探讨结扎速血管闭合系统(LigaSure)与双极电刀在腹腔镜巨大子宫切除术中联合应用的手术技巧与安全性。方法:选取2008年1月至2013年12月收治的168例子宫肌瘤患者为研究对象,均行腹腔镜全子宫切除术。患者根据自己的意愿选择手术器材,并根据所用器材将168例患者分为A组与B组,A组(n=83)采用LigaSure与双极电刀,B组(n=85)采用双极电刀。对比两组中转开腹率、手术时间、术中出血量、术后排气时间、术后住院时间、术后并发症发生率。结果:A组中转开腹率为3.6%,B组为4.7%,差异无统计学意义(P>0.05)。A组手术时间、术中出血量均少于B组,差异有统计学意义(P<0.05)。两组术后排气时间、术后住院时间差异无统计学意义(P>0.05)。A组1例子宫腺肌病患者术后1周内出现左侧输卵管轻度扩张、左侧肾轻度积水,经两周抗炎治疗后好转出院。B组患者术后未发生严重并发症,差异无统计学意义(P>0.05)。结论:子宫切除术中采用LigaSure与双极电刀进行操作,手术时间较短,术中出血量较少,且临床疗效与单纯使用双极电刀无明显差异,可促进腹腔镜巨大子宫切除术的普及与推广。Objective ：To investigate the surgical techniques and safety of vessel sealing system （LigaSure） and bipolar electrosurgical generator in laparoscopic hysterectomy for enormous uterus. Methods： From Jan. 2008 to Dec. 2013,168 patients with uterine fibroids were selected for the study, all patients were treated with laparoscopic total hysterectomy. Surgical instruments were selected according to patients＇ wishes, and according to the surgical equipment used the 168 patients were divided into group A （ n = 83, LigaSurc and bipolar electric knife） and group B （n = 85 ,bipolar electrosurgical generator）. Conversion to open surgery, operative time, blood loss, postoperative exhaust time, postoperative hospital stay, incidence of postoperative complications were compared between the two groups. Results：In group A the rate of conversion to laparotomy was 3.6 %, and 4.7 % in the group B, the difference was not statistically significant （P 〉 0. 05 ）. The operative time and blood loss of group A were less than those of group B （ P 〈 0.05 ）. The postoperative exhaust time and postoperative hospital stay of two groups was not statistically different （P 〉 0. 05）. In group A, 1 patient with uterine adenomyosis was found mild extension of left fallopian tube, mild hydronephrosis of the left kidney within 1 week, after anti-inflammatory treatment of 2 weeks,this patient improved and was discharged. Patients in group B did not suffer from serious complications, the difference was not statistically significant （ P 〉 0. 05 ）. Conclusions ： Using LigaSure and bipolar electric knife in hysterectomy has shorter operative time,less blood loss, and the clinical efficacy is similar with simple use of bipolar electric knife, this procedure can promote the popularization of laparoscopic hysterectomy for enormous uterus.

关 键 词：平滑肌瘤 LIGASURE 双极电刀 子宫切除术 巨大子宫 腹腔镜检查 

分 类 号：R713.42[医药卫生—妇产科学]