经阴道全子宫切除术与腹腔镜下全子宫切除术治疗子宫肌瘤的临床效果对比分析  

Comparative analysis of the clinical effect of transvaginal total hysterectomy and laparoscopic total hysterectomy in the treatment of uterine fibroids

作　　者：郑春艳 张超 张顺仓 安旭琢 李江鹏 左侠 李阳 叶敏 郑丽霞 ZHENG Chun-yan;ZHANG Chao;ZHANG Shun-cang;AN Xu-zhuo;LI Jiang-peng;ZUO Xia;LI Yang;YE Min;ZHENG Li-xia(Department of Obstetrics and Gynecology,Xingyuan Hospital of Yulin,Yulin,Shaanxi 719000,China;不详)

机构地区：[1]榆林市星元医院妇产科,陕西榆林719000 [2]西安市人民医院西安市第四医院

出　　处：《中国妇幼保健》2023年第15期2898-2903,共6页Maternal and Child Health Care of China

基　　金：陕西省重点研发计划项目(2020SF-307);陕西省榆林市科技局研发计划项目(YF-2020-165)。

摘　　要：目的 分析、评估经阴道全子宫切除术(TVH)和腹腔镜下全子宫切除术(TLH)两种手术方式治疗子宫肌瘤的临床疗效,建立支持TVH治疗子宫肌瘤的循证医学依据。方法 选取榆林市星元医院2020年1月—2021年12月收治的231例因子宫肌瘤住院行全子宫切除术患者进行回顾性分析。将231例患者随机分为观察组(108例)和对照组(123例)。观察组行经阴道全子宫切除术,对照组行腹腔镜下全子宫切除术。记录患者术前、术中及术后相关临床数据,对两组患者住院时间、术后并发症发生率进行对比分析。结果 比较两组切除子宫组织重量、手术时间、术中出血量及手术治疗费用,观察组切除子宫组织重量及术中出血量[(354.6±83.8)g与(104.9±46.5)ml]与对照组[(362.2±84.1)g与(107.2±42.8)ml]比较,差异均无统计学意义(t=11.14、8.15,均P>0.05)。观察组手术时间[(73.6±13.8)min]短于对照组[(98.7±16.4)min],差异有统计学意义(t=8.63,P<0.05)。两组手术治疗费用相比,观察组[(8 036.1±958.6)元]少于对照组[(10 047.2±789.1)元],差异有统计学意义(t=9.11,P<0.05)。观察组术后肛门首次排气时间、术后首次下床活动时间及住院时间[(14.6±1.8)h、(14.6±1.8)h与(5.6±2.5)d]均短于对照组[(25.8±8.7)h、(19.7±2.7)h与(7.3±2.1)d],差异均有统计学意义(t=7.4、4.1及2.8,均P<0.05)。观察组术后5 h VAS评分、术后10 h VAS评分及术后24 h VAS评分[(2.9±1.5)分、(2.4±1.4)分、(1.8±0.9)分]均低于对照组[(5.7±2.8)分、(3.9±2.7)分、(2.7±1.4)分],差异均有统计学意义(t=5.6、2.4及4.8,均P<0.05)。观察组发生术后并发症4例,对照组发生术后并发症8例,观察组术后并发症发生率[3.70%(4/108)]低于对照组[6.50%(8/123)],差异有统计学意义(t=4.82,P<0.05)。结论 经阴道全子宫切除术治疗子宫肌瘤可以取得确切效果,还具有创伤小、术后恢复快、术后并发症少、腹部无瘢痕等诸多优点。此外,经阴道Objective To analyze and evaluate the clinical efficacy of transvaginal total hysterectomy(TVH) and laparoscopic total hysterectomy(TLH) in the treatment of uterine fibroids,and to establish evidence-based medical evidence supporting the treatment of uterine fibroids by transvaginal total hysterectomy(TVH).Methods A total of 231 patients who underwent total hysterectomy due to uterine fibroids admitted to Xingyuan Hospital of Yulin from January 2020 to December 2021 were selected as the research objects for retrospective analysis.231 patients were randomly divided into observation group(108 cases) and control group(123 cases).The observation group underwent transvaginal hysterectomy and the control group underwent laparoscopic hysterectomy.The preoperative,intraoperative and postoperative clinical data were recorded,and the length of hospital stay and the incidence of postoperative complications were compared between the two groups.Results The weight of hysterectomy tissue,operation time,intraoperative blood loss and surgical treatment cost of the two groups were compared.There was no significant difference between the observation group and the control group [(362.2±84.1) g and(107.2±42.8) ml] in the weight of the resected uterine tissue and the intraoperative blood loss [(354.6±83.8) g and(104.9±46.5) ml](t=11.14,8.15,P<0.05).The operation time of observation group [(73.6±13.8) min] was shorter than that of control group [(98.7±16.4) min],and the difference was statistically significant(t=8.63,P<0.05).Compared with the two groups,the surgical treatment cost in the observation group [(8 036.1 ±958.6) RMB] was less than that in the control group [(10 047.2±789.1)RMB],and the difference was statistically significant(t=9.11,P<0.05).The time of first postoperative anal exhaust,the time of first postoperative ambulation and the length of hospital stay [(14.6±1.8) h,(14.6±1.8) h and(5.6±2.5) d] in the observation group were shorter than those in the control group [(25.8±8.7) h,(19.7±2.7) h and(7.3± 2.1) d

关 键 词：子宫肌瘤 经阴道全子宫切除术 腹腔镜下全子宫切除术 微创 

分 类 号：R737.33[医药卫生—肿瘤]