腹腔镜大子宫切除术中经粉碎器取出标本的有效性及安全性  

Efficacy and safety of removing specimens by pulverizer in laparoscopic major hysterectomy

作　　者：范丹丹 张桂香 高曼 FAN Dandan;ZHANG Guixiang;GAO Man(Yongcoal Group General Hospital,Shangqiu 476600,China)

机构地区：[1]永煤集团总医院,河南商丘476600

出　　处：《临床医学研究与实践》2025年第12期82-85,共4页Clinical Research and Practice

摘　　要：目的探讨腹腔镜大子宫切除术中经粉碎器取出标本的有效性及安全性。方法选择2021年8月至2023年5月本院收治的81例需行腹腔镜下全子宫切除术的大子宫患者作为研究对象,采用随机数字表法将其分为粉碎器组(n=41)和阴式组(n=40)。粉碎器组经粉碎器取出标本,阴式组经阴道取出标本。比较两组的手术相关指标、血清指标及并发症发生情况。结果两组的中转开腹率比较,差异无统计学意义(P>0.05);粉碎器组的子宫取出时间、手术时间及术后排气时间短于阴式组,术中出血量少于阴式组,差异具有统计学意义(P<0.05)。术后48 h,两组的C反应蛋白(CRP)及白细胞介素-6(IL-6)水平均高于术前,但粉碎器组低于阴式组(P<0.05)。粉碎器组的阴道残端损伤、阴道壁裂伤及胱损伤发生率低于阴式组(P<0.05);两组的并发症性腹膜平滑肌瘤病、医源性寄生性子宫肌瘤、子宫内膜异位症、肠管挫伤及盆腔血肿发生率比较,差异无统计学意义(P>0.05)。结论在排除禁忌证情况下,腹腔镜大子宫切除术中经粉碎器取出标本的操作更便捷,术中副损伤小。Objective To investigate the efficacy and safety of removing specimens by pulverizer in laparoscopic major hysterectomy.Methods A total of 81 patients with large uterus who underwent laparoscopic total hysterectomy in our hospital from August 2021 to May 2023 were selected as the study subjects,the patients were divided into pulverizer group(n=41)and vaginal group(n=40)by random number table method.The specimens of the pulverizer group were taken out by the pulverizer,the specimens of the vaginal group were taken out by the vagina.The operation related indexes,serum indexes and complications were compared between the two groups.Results There was no significant difference in the conversion rate for open surgery between the two groups(P>0.05);the uterine removal time,operation time and postoperative exhaust time of the pulverizer group were shorter than those of the vaginal group,and the intraoperative blood loss was less than that of the vaginal group,the differences were statistically significant(P<0.05).At 48 h after operation,the levels of C-reactive protein(CRP)and interleukin-6(IL-6)in the two groups were higher than those before operation,but those in the pulverizer group were lower than the vaginal group(P<0.05).The incidence of vaginal stump injury,vaginal wall laceration and cyst injury in the pulverizer group were lower than those in the vaginal group(P<0.05);there were no significant differences in the incidence of complications of peritoneal leiomyomatosis,iatrogenic parasitic uterine fibroids,endometriosis,intestinal contusion and pelvic hematoma between the two groups(P>0.05).Conclusion In the case of exclusion of contraindications,the operation of taking out the specimen by the pulverizer in laparoscopic major hysterectomy is more convenient and the intraoperative side injury is small.

关 键 词：腹腔镜 大子宫 全子宫切除术 电动子宫粉碎器 

分 类 号：R737.33[医药卫生—肿瘤]