非脱垂子宫良性病变行不同全子宫切除方式的疗效对比  

Comparison of therapeutic effect of different total hysterectomy for non-prolapse uterine benign lesions

作　　者：邱建[1] 姚国荣[1] 曹明月[1] 朱军梅[1] 黄筱竑[1] QIU Jian;YAO Guorong;CAO Mingyue;ZHU Junmei;HUANG Xiaohong(Department of Gynecology and Obstetrics,Huzhou Central Hospital,Central Hospital Affiliated to Huzhou Normal University,Huzhou 313000,China)

机构地区：[1]湖州市中心医院湖州师范学院附属中心医院妇产科,浙江湖州313000

出　　处：《中国现代医生》2022年第5期81-85,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2019ZH043)。

摘　　要：目的探讨经阴道、腹腔镜及经腹三种不同全子宫切除手术方式治疗非脱垂子宫良性病变的临床效果。方法选择2017年1月至2019年12月在湖州市中心医院住院拟行全子宫切除术的患者200例作为研究对象,采用随机数表法分为三组,分别给予不同的手术处理方式:经腹全子宫切除术(组1)、腹腔镜下全子宫切除术(组2),经阴道全子宫切除术(组3),对比分析三组患者的一般临床特征、术中手术总时长、出血量、肛门排气时间、术后疼痛评分、住院时间、住院费用、并发症等情况,并进行满意度评价。结果三组患者的年龄、疾病种类、子宫大小比较,差异无统计学意义(P>0.05);组2及组3的出血量均明显少于组1(P=0.007),且肛门排气恢复时间、术后疼痛评分均优于组1,以组3更为显著,差异有统计学意义(P<0.05);组1及组3的平均住院费用显著低于组2,差异有统计学意义(P<0.05);三组的手术时间、住院时间、并发症等方面比较,差异无统计学意义(P>0.05),术后问卷调查显示组2及组3患者对手术的满意度较组1明显增高,差异有统计学意义(P=0.026)。结论相比经腹及腹腔镜全子宫切除术,经阴道全子宫切除术具有创伤小、出血少、术后疼痛更轻、恢复快、住院费用低等优势,且体表不留瘢痕,具有较好的临床治疗效果,值得推广及应用。Objective To investigate the clinical effects of three different methods of total hysterectomy,including transvaginal total hysterectomy,laparoscopic total hysterectomy and transabdominal total hysterectomy,in the treatment of non-prolapse uterine benign lesions.Methods A total of 200 patients who were hospitalized in Huzhou Central Hospital from January 2017 to December 2019 and planned to undergo total hysterectomy were selected as the research objects.They were divided into three groups by the random number table method and given different surgical treatment methods:transabdominal total hysterectomy(Group 1),laparoscopic total hysterectomy(Group 2)and transvaginal total hysterectomy(Group 3).The general clinical characteristics,total durations of operation,amounts of blood loss,anal exhaust time,postoperative pain scores,length of hospital stay,hospitalization costs,complications and other conditions of patients in the three groups were compared and analyzed,and the satisfaction evaluations were conducted.Results No significant differences were observed in age,disease type and uterine size among the three groups(P>0.05).The amounts of blood loss in Group 2 and Group 3 were significantly less than the amount of blood loss in Group 1(P=0.007),and the recovery time of anal exhaust and postoperative pain scores in Group 1 and especially Group 3 was better than that in Group 1,and the differences were statistically significant(P<0.05).The average hospitalization costs of Group 1 and Group 3 were significantly lower than the cost of Group 2,with statistically significant differences(P<0.05).No significant differences were observed in operation durations,length of hospital stay and complications among the three groups(P>0.05).Postoperative questionnaire survey showed that the satisfaction of patients in Group 2 and Group 3 was significantly higher than that in Group 1,and the difference was statistically significant(P=0.026).Conclusion Compared with transabdominal and laparoscopic total hysterectomy,transvaginal tota

关 键 词：经阴道全子宫切除术 腹腔镜全子宫切除术 经腹全子宫切除术 非脱垂子宫 

分 类 号：R713.4[医药卫生—妇产科学]