两种子宫血管处理方法在腹腔镜下子宫全切除术中的比较  

Comparison of Two Methods of Uterine Vascular Treatment in Laparoscopic Hysterectomy

作　　者：陈泗总 CHEN Sizong(Sanming First Hospital Affiliated to Fujian Medical University,Sanming 365000,China)

机构地区：[1]福建医科大学附属三明第一医院,福建三明365000

出　　处：《中外医学研究》2020年第15期6-8,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：三明市科技计划项目(项目编号:2017-5-3)。

摘　　要：目的:比较腹腔镜下子宫全切除中子宫动静脉缝扎法与游离法的应用效果。方法:选取2017年10月-2018年10月笔者所在单位收治行腹腔镜下子宫全切术的120例患者作为研究对象,根据不同子宫血管处理方法分成观察组和对照组,各60例。对照组患者采取子宫动静脉游离法处理,观察组采取子宫动静脉缝扎后电凝法。比较两组患者手术一般情况、拔除尿管时间、肛门排气时间、体温恢复时间、住院时间、手术前后血红蛋白(Hb)差值以及术后并发症等指标。结果:两组患者术中出血量、手术时间相比,差异有统计学意义(P<0.05);两组住院天数相比,差异无统计学意义(P>0.05)。两组患者在拔除尿管时间、肛门排气时间、体温恢复时间相比,差异无统计学意义(P>0.05);两组患者手术前后的Hb差值相比,差异有统计学意义(P<0.05)。术后主要并发症有感染、输尿管热损伤、膀胱损伤等,观察组总发生率为3.3%,对照组为18.3%,组间差异有统计学意义(P<0.05)。结论:腹腔镜子宫全切术中采用缝扎后电凝法处理子宫动静脉的效果更可靠,术中出血少,并发症更少,安全性更高。Objective:To compare the application effect of uterine artery and vein suture and free method in laparoscopic hysterectomy.Method:From October 2017 to October 2018,120 patients who underwent laparoscopic total hysterectomy were selected as the study objects.According to different uterine vascular treatment methods,they were divided into observation group and control group,60 cases in each group.The patients in the control group were treated with the method of uterine arteriovenous dissociation,and the patients in the observation group were treated with the method of electrocoagulation after uterine arteriovenous suture.The general condition of operation,the time of catheter removal,the time of anal exhaust,the time of body temperature recovery,the time of hospitalization,the difference of hemoglobin(Hb)before and after operation and the postoperative complications were compared between the two groups.Result:The bleeding volume and operation time of the two groups were compared,the differences were significant(P<0.05).The hospitalization days of the two groups were compared,the differences was not significant(P>0.05).The time of extubation,anal exhaust and body temperature recovery in the two groups had no significant difference(P>0.05).The difference of Hb before and after operation between the two groups had significant difference(P<0.05).The main complications were infection,ureteral heat injury and bladder injury.The total incidence of the observation group was 3.3%,and that of the control group was 18.3%(P<0.05).Conclusion:The method of electrocoagulation after ligation is more reliable,less bleeding,less complications and higher safety in laparoscopic total hysterectomy.

关 键 词：腹腔镜下子宫全切术 子宫肌瘤 子宫腺肌症 血管处理 

分 类 号：R713.42[医药卫生—妇产科学]