经腹与经腹腔镜下大子宫切除术的回顾性队列研究  

Retrospective Cohort Study of Transabdominal and Laparoscopic Hysterectomy

作　　者：朱雪娇 李伟 王新平 邓杰 ZHU Xue-jiao;LI Wei;WANG Xin-ping;Deng Jie(Department of Obstetrics and Gynecology,Xiangyang No.1 People's Hospital,Hubei University of Medicine,Xiangyang,Hubei 441011,China)

机构地区：[1]湖北医药学院附属襄阳市第一人民医院妇产科,湖北襄阳441011

出　　处：《湖北医药学院学报》2022年第5期476-479,共4页Journal of Hubei University of Medicine

基　　金：湖北省卫生健康委指导性项目(WJ2021F069)。

摘　　要：目的:对比分析经腹和经腹腔镜下大子宫切除术的相关手术指标。方法:回顾性分析湖北医药学院附属襄阳市第一人民医院2015年1月至2021年12月因良性疾病而行子宫切除术患者的病例资料,符合纳入、排除标准的病例共计437例,分为开腹手术组(n=104例)与腹腔镜手术组(n=333例)。比较两组患者的年龄、体质指数(body mass index,BMI)、绝经情况、病因、手术时间、术中出血量、术后排气时间、住院天数、住院总费用及术后并发症。结果:腹腔镜组大子宫切除术大部分集中于子宫体12~15孕周大小,而子宫体大于20孕周的患者,全部经腹手术,差异有统计学意义(P<0.001)。两组患者年龄、BMI、绝经情况、病因、手术时间、术后排气时间、残端愈合不良、泌尿系损伤、肠道损伤结果比较,差异无统计学意义(P>0.05);腹腔镜组术中出血量少、感染少、住院天数短,差异有统计学意义(P<0.05)。结论:腹腔镜下大子宫切除术是安全的,但是需要严格掌握适应证,对于巨大子宫切除术,经腹手术反而是更好的选择。Objective To compare and analyze the relevant surgical indicators of transabdominal and laparoscopic hysterectomy.Methods Retrospective analysis was made on the case data of patients undergoing hysterectomy due to benign diseases from January 2015 to December 2021 in Xiangyang First People’s Hospital affiliated to Hubei University of Medicine.A total of 437 cases met the inclusion and exclusion criteria,which were divided into the laparotomy group(n=104 cases)and the laparoscopic hand operation group(n=333 cases).The age,body mass index(BMI),menopause,etiology,operation time,intraoperative bleeding,postoperative exhaust time,hospitalization days,total hospitalization cost and postoperative complications of the two groups were compared.Results In the laparoscopic surgery group,most of the large hysterectomy was performed on the uterus at 12-15 gestational weeks,while in the patients with uterus greater than 20 gestational weeks underwent abdominal surgery,with a statistically significant difference(P<0.001).There were no significant differences in age,BMI,menopause,etiology,operation time,postoperative exhaust time,poor stump healing,urinary system injury and intestinal injury between the two groups(P>0.05).The laparoscopic group had less intraoperative bleeding,less infection and shorter hospitalization stay with a statistically significant difference(P<0.05).Conclusion Laparoscopic huge hysterectomy is safe,but the indications need to be strictly controlled.For giant hysterectomy,transabdominal hysterectomy is actually a better choice.

关 键 词：腹腔镜子宫切除术 大子宫 安全性 并发症 

分 类 号：R713.42[医药卫生—妇产科学]