腹腔镜与经腹全子宫切除术的效果比较及临床体会  

Compare on the Effects of Total Laparoscopic and Total Abdominal Hysterectomy and Surgical Experience

作　　者：张雪刚[1] ZHANG Xue-gang(Kunshan First People S Hospital Affiliated to Jiangsu University, Jiangsu Kunshan 215300)

机构地区：[1]江苏大学附属昆山第一人民医院,江苏昆山215300

出　　处：《世界最新医学信息文摘》2017年第14期83-84,共2页World Latest Medicine Information Electronic Version

摘　　要：目的比较腹腔镜下全子宫切除术(total laparoscopic hysterectomy,TLH)与经腹全子宫切除术(total abdominal hysterectomy,TAH)的效果。方法回顾性分析2010年1月至2016年12月在昆山市第一人民医院院行腹腔镜下全子宫切除术124例病例,同期内经腹全子宫切除术182例病例。比较上述两种手术方式的手术时间、术中出血量、术后镇痛、术后体温、排气时间、术后住院时间术后抗生素应用时间以及术后并发症等。结果腹腔镜手术组术中出血量(120.1±32.8)m L显著少于经腹手术组(264±52.4)m L(P<0.05);腹腔镜组术后镇痛14例,明显低于经腹手术组89例(χ2=46.72,P<0.01);腹腔镜组排气时间(33.8±12.1)h,明显短于经腹手术组(53.8±12.4)h(P<0.05);腹腔镜组术后住院时间(5.3±1.1)d,明显少于经腹手术组(7.2±1.3)d(P<0.05);以上两组在手术时间、术后体温、术后抗生素应用以及术后并发症方面无统计学意义(P>0.05)。结论腹腔镜与经腹全子宫切除术相比,具有创伤小、患者恢复快等优点,同时并不增加手术风险和术后并发症。Objective To evulate the effects of total Laparoscopic hysterectomy（TLH） and total abdominal hysterectomy（TAH）. Methods A retrospective analysis was made on clinica1 data of 124 cases of TLH and 182 cases of TAH from January 2010 to January 2016 in this hospital. The operation time, blood loss, postoperative analgesia, postoperative body temperature, time to first passing flatus, postoperative hospital stay, postoperative antibiotics, time and postoperative complications were respectively compared between the two groups. Results Blood loss of laparoscopic surgery group（120.1±32.8） was significantly less than the abdominal surgery group（264±52.4） ml（P〈0.05）; Laparoscopic group, 14 cases of postoperative analgesia, significantly less than 89 cases of abdominal surgery group（χ^2=46.72, P〈0.01）; time to first passing flatus of the laparoscopic group（33.8±12.1） h, significantly shorter than the abdominal surgery group（53.8±12.4） h（P〈0.05）; laparoscopic group, postoperative hospital stay（5.3 ± 1.1） d, significantly less than the abdominal surgery group（7.2±1.3） d（P〈0.05）; The operative time, postoperative body temperature, time of postoperative antibiotics, and postoperative complications were no statistically significant（P〈0.05） between the two groups. Conclusion Compared with total abdominal hysterectomy, total Laparoscopic hysterectomy is less invasive, quick recovery, and at the same time does not increase the surgical risk and postoperative complications.

关 键 词：腹腔镜 全子宫切除 镇痛 

分 类 号：R713.42[医药卫生—妇产科学]