探讨腹腔镜下经膀胱侧入层次分离法行大子宫全切除术的可行性和优越性  

To Explore the Feasibility and Superiority of Laparoscopic Total Hysterectomy with Lateral Bladder Entry and Hierarchical Separation

作　　者：蒋荣梅 JIANG Rong-mei(Department of Obstetrics and Gynecology,Zaoqiang County People’s Hospital,Hengshui City,Hebei Province,Hengshui Hebei,053100,China)

机构地区：[1]衡水市枣强县人民医院妇产科,河北衡水053100

出　　处：《中华养生保健》2023年第4期172-175,共4页CHINESE HEALTH CARE

摘　　要：目的评估腹腔镜下经膀胱侧入层次分离法应用在大子宫全切除术中的可行性及优越性。方法选取2020年1月-2021年8月衡水市枣强县人民医院收治且行全子宫全切除术(TLH)的60例子宫肌瘤患者作为研究对象,按照随机数表法将患者分为对照组和观察组,每组30例。对照组采用直入法,观察组采用侧入法,评价两组术中指标、恢复情况、随访情况。结果与对照组比较,观察组平均出血量、平均手术时间、平均离床时间、平均住院时间更少,差异有统计学意义(P<0.05);两组平均肛门排气时间、术后5 d平均体温比较,差异无统计学意义(P>0.05);随访3个月,除对照组出现3例慢性腹痛,两组阴道断端、腹壁创口均恢复良好,均未见排尿障碍、盆腔粘连增厚等并发症。结论在子宫肌瘤患者中经膀胱侧入层次分离法行TLH,手术创伤轻,离床时间与住院时间少,可行性强,值得临床应用。Objective To evaluate the feasibility and superiority of laparoscopic transvesical dissection in total hysterectomy.Methods 60 patients with uterine leiomyoma who were admitted to Zaoqiang County People’s Hospital of Hengshui City,Hebei Province from January 2020 to August 2021 and underwent total hysterectomy(TLH)were included.All the subjects were divided into the control group(30 cases were included,using direct entry method)and the observation group(30 cases were included,using lateral entry method).The intraoperative indicators,recovery and follow-up between the groups were evaluated.Results Compared with the control group,the average bleeding volume,the average operation time,the average time out of bed and the average hospitalization time in the observation group were less(P<0.05),but there was no diff erence in the average anal exhaust time and the average body temperature fi ve days after operation between the two groups(P>0.05);during the follow-up of 3 months,except for 3 cases of chronic abdominal pain in the control group,the vaginal broken ends and abdominal wall wounds in both groups recovered well,and there were no complications such as dysuria and pelvic adhesion thickening.Conclusion TLH performed by bladder lateral approach in patients with uterine leiomyoma has the advantages of less trauma,less time out of bed and hospitalization,strong feasibility,and is worth popularizing.

关 键 词：腹腔镜下经膀胱侧入层次分离法 大子宫全切除术 可行性 优越性 

分 类 号：R713.42[医药卫生—妇产科学]