改良式腹腔镜辅助经阴全子宫切除术的优势  

Advantages of modified laparoscopic assisted transvaginal hysterectomy

作　　者：王文越[1] 赵霞 庄文亭 张纪存 WANG Wenyue;ZHAO Xia;ZHUANG Wenting;ZHANG Jicun(Department of Obstetrics,Weifang Hospital of Traditional Chinese Medicine,Weifang 261041,China;Department of Vascular Surgery,Weifang People’s Hospital)

机构地区：[1]潍坊市中医院妇科,山东潍坊261041 [2]潍坊市人民医院血管外科

出　　处：《潍坊医学院学报》2022年第5期358-360,共3页Acta Academiae Medicinae Weifang

摘　　要：目的分析改良式腹腔镜辅助经阴全子宫切除术的优点及可行性。方法对2019年1月~2021年12月行改良式腹腔镜辅助经阴全子宫切除术100例患者的临床资料进行回顾性分析,并与传统腹腔镜辅助经阴全子宫切除术的100例患者进行对比,包括:膀胱直肠损伤、手术时间、术中出血量、术后感染率、术后阴道残端炎性反应、术后下床活动时间、术后肛门排气时间、术后住院时间。结果改良式腹腔镜辅助经阴全子宫切除术与传统腹腔镜辅助经阴全子宫手术对比,膀胱直肠损伤减少(P<0.05),手术时间短(P<0.05),术中出血量少(P<0.05),术后感染率低(P<0.05),术后阴道残端炎性反应减少(P<0.05),术后下床活动时间、术后肛门排气时间、术后住院时间无明显差异(P>0.05)。结论腹腔镜辅助经阴全子宫切除术采用改良术式临床效果显著,既可缩短手术时间,减少术中出血,又可减少术中、术后并发症的发生,同时针对大子宫患者术中放置套袋可减少部分恶性病变(术后病理证实)、部分肌瘤碎屑种植的可能,提高愈合效果,值得临床推广应用。Objective To study and analyze the advantages and feasibility of modified laparoscopic assisted transvaginal hysterectomy.Methods The clinical data of 100 patients who underwent modified laparoscopic assisted transvaginal hysterectomy from January 2019 to December 2021 were analyzed retrospectively and compared with 100 patients who underwent traditional laparoscopic assisted transvaginal hysterectomy,include:bladder and rectum injury,operation time,intraoperative bleeding,postoperative infection rate,postoperative inflammatory reaction of vaginal stump,postoperative out of bed activity time,postoperative anal exhaust time.There was no significant difference in postoperative hospital stay.Results Compared with the traditional laparoscopic assisted transvaginal hysterectomy,the modified laparoscopic assisted transvaginal hysterectomy had less bladder and rectum injury(P<0.05),shorter operation time(P<0.05),less intraoperative bleeding(P<0.05),lower postoperative infection rate(P<0.05),less postoperative inflammatory reaction of vaginal stump(P<0.05),postoperative out of bed activity time,postoperative anal exhaust time.There was no significant difference in postoperative hospital stay(P>0.05).Conclusion The clinical effect of laparoscopic assisted transvaginal hysterectomy is remarkable.It not only shortens the operation time,reduces intraoperative bleeding,but also reduces the occurrence of intraoperative and postoperative complications.At the same time,for patients with large uterus,the placement of bagging during operation reduces the possibility of planting some malignant lesions(confirmed by postoperative pathology)and some leiomyoma debris,and improves the healing effect.It is worthy of extensive clinical application.

关 键 词：改良 腹腔镜 全子宫切除术 

分 类 号：R713.42[医药卫生—妇产科学]