非脱垂困难子宫经阴道与腹腔镜辅助阴式全切术的临床效果及手术前后睡眠质量比较  

Clinical Effect of Transvaginal and Laparoscopically Assisted Vaginal Total Hysterectomy and Comparison of Sleep Quality Before and after Operation for Difficult Uterus without Prolapse

作　　者：丁伟芳 李立安[2] 李红霞[3] Ding Weifang;Li Li＇an;Li Hongxia(Beijing Water Conservancy Hospital, Beijing, 100036;Chinese people＇s Liberation Army General Hospital, Beijing, 100039;Capital Medical University affiliated Beijing Century altar Hospital, Beijing, 100038)

机构地区：[1]北京水利医院,北京100036 [2]中国人民解放军总医院,北京100039 [3]首都医科大学附属北京世纪坛医院,北京100038

出　　处：《世界睡眠医学杂志》2018年第2期144-148,共5页World Journal of Sleep Medicine

摘　　要：目的:比较非脱垂困难子宫在经阴道、腹腔镜辅助阴式子宫全切术2种微创手术方法中的临床疗效。探讨切除非脱垂困难子宫的术式选择的有关问题,比较2组患者术后睡眠质量。方法:回顾性分析2014年1月至2016年6月良性非脱垂困难子宫采用经阴道全子宫切除术(Transvaginal Hysterectomy,TVH)56例及腹腔镜辅助阴式子宫全切术(Laparoscopically Assisted Vaginal Hysterectomy,LAVH)77例的完整临床资料,并对此进行比较分析。结果:TVH、LAVH在术后排气、术后病率、术中器官损伤,术中输血比较差异无统计学意义(P>0.05)、但在手术时间、术后出血、术后住院天数及住院费用比较差异有统计学意义(P<0.05);2组患者在术前数据比较不具有统计学意义,在术后,LAVH组PSQI的分值为(6.53±1.87),TVH组PSQI的分值为(12.82±3.55),LAVH组低于TVH组(P<0.05)。两例术中器官损伤患者均为膀胱受损。结论:在充分评估后非脱垂困难子宫采用腹腔镜辅助阴式子宫全切术比阴道全切术有明显的优势。Objective： To compare the clinical effect of two minimally invasive methods of transvaginal and laparoscopically assisted vaginal hysterectomy for difficult uterus with non-prolapsed uterus,to discuss the selection of surgical methods for the removal of difficult uterus without prolapse,and to compare the postoperative sleep quality of the two groups. Methods： From January 2014 to June 2016,the complete clinical data of 56 cases of transvaginal hysterectomy with transvaginal hysterectomy and 77 cases of laparoscopic assisted vaginal hysterectomy were retrospectively analyzed.Results： TVH,LAVH in the postoperative exhaust, postoperative morbidity, organ injury, there was no significant difference in blood transfusion group（ P〈0. 05）,but at the time of surgery,postoperative bleeding,postoperative hospital stay and there was a significant difference between the hospitalization expenses（ P〈0. 05）; 2 patients in the preoperative data comparison with statistical significance,in the LAVH group after operation,PSQI score（ 6. 53 ± 1. 87）,The score of PSQI in TVH group was lower than that in TVH group（ 12. 82 ± 3. 55）（ P〈0. 05）. Conclusion： Laparoscopic assisted vaginal hysterectomy has obvious advantages over vaginal hysterectomy after full evaluation of non-prolapse difficult uterus.

关 键 词：经阴道子宫全切 腹腔镜辅助阴式子宫全切 非脱垂大子宫 

分 类 号：R711.74[医药卫生—妇产科学]