早切开前穹隆行腹腔镜子宫全切除术在预防泌尿系统损伤中的价值  

Value of Early Incision of the Anterior Vault for Laparoscopic Total Hysterectomy in the Prevention of Urinary System Injury

作　　者：党丽娟 徐晓涵 陈瑾 孟海红[3] 王廷涛[1] 王云飞[1] 杨林青[1] DANG Lijuan;XU Xiaohan;CHEN Jin;MENG Haihong;WANG Tingtao;WANG Yunfei;YANG Linqing(Department of Gynecology,Affiliated Hospital of Jining Medical University,Jining,Shandong Province,272129 China;Department of Gynecology,Jining Medical University,Jining,Shandong Province,272129 China;Operating Room,Affiliated Hospital of Jining Medical University,Jining,Shandong Province,272129 China)

机构地区：[1]济宁医学院附属医院妇科,山东济宁272129 [2]济宁医学院妇科,山东济宁272129 [3]济宁医学院附属医院手术室,山东济宁272129

出　　处：《中外医疗》2022年第34期72-76,共5页China & Foreign Medical Treatment

摘　　要：目的研究早切开前穹隆行腹腔镜子宫全切除术在预防泌尿系统损伤中的价值。方法方便选取2019年1月-2021年12月在济宁医学院附属医院妇科拟行腹腔镜子宫全切除术者220例作为研究组,术中在分离膀胱后,处理子宫血管前即先切开前穹隆,将已暴露的举宫杯作为处理子宫血管及主韧带的标志。另取同期按常规步骤行腹腔镜子宫全切除术者220例,为对照组。比较两组手术相关指标、并发生情况、术后疼痛程度、泌尿系统损伤及术后性生活恢复时间等,检测两组应激因子的水平。结果两组的手术时间、拔除气管导管时间及术后住院天数,差异无统计学意义(t=1.182、1.284、1.483,P>0.05);研究组的出血量(30.6±20.6)mL少于对照组,术后首次通气时间(14.4±4.8)h短于对照组,差异有统计学意义(t=15.972、4.058,P<0.001)。两组的手术并发症发生率,差异无统计学意义(χ^(2)=3.707,P=0.054)。研究组泌尿系统损伤少于对照组,差异有统计学意义(χ^(2)=1.821,P<0.05)。研究组术后性生活恢复时间(70.4±5.9)d明显短于对照组,差异有统计学意义(t=7.680,P<0.001)。结论早切开前穹隆行腹腔镜子宫全切除术可减少术中出血,减少泌尿系统损伤的机会,缩短术后性生活恢复时间,具有实用价值。Objective To study the value of early incision of the anterior vault for laparoscopic total hysterectomy in the prevention of urinary system injury.Methods A total of 220 patients undergoing laparoscopic hysterectomy in the Department of Gynecology of the Affiliated Hospital of Jining Medical College from January 2019 to December 2021 were conveniently selected as the study group.During the operation,the anterior fornix was first cut,after the separation of the bladder and before the treatment of uterine blood vessels,and the exposed uterine cup was used as a marker for the treatment of uterine blood vessels and main ligaments.Another 220 patients who underwent laparoscopic hysterectomy according to routine procedures during the same period were selected as the control group.Compare the surgical related indicators,complications,postoperative pain level,urinary system injury,and recovery time of sexual life between the two groups,and detect the level of stress factors in the two groups.Results There was no statistically significant difference between the two groups in operation time,tracheal catheter removal time and postoperative hospitalization days(t=1.182,2.284,1.483,P>0.05);the bleeding volume of the study group was(30.6±20.6)mL,less than that of the control group,and the first ventilation time after operation was(14.4±4.8)h,shorter than that of the control group,with a statistically significant difference(t=15.972,4.058,P<0.001).There was no statistically significant difference in the incidence of surgical complications between the two groups(χ^(2)=3.707,P=0.054).The urinary system injury in the study group was less than that in the control group,the difference was statistically significant(χ^(2)=1.821,P<0.05).The recovery time of sexual life in the study group(70.4±5.9)d after operation was significantly shorter than that in the control group,the difference was statistically significant(t=7.680,P<0.001).Conclusion Early incision of the anterior vault for laparoscopic total hysterectomy can reduce intra

关 键 词：腹腔镜子宫全切除术 并发症 早切开前穹隆 泌尿系统损伤 

分 类 号：R5[医药卫生—内科学]