Clinical comparison between laparoscopic assisted vaginal hysterectomy and vaginal hysterectomy
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摘要: 目的 比较腹腔镜辅助阴式子宫切除术与阴式子宫切除术的临床疗效,以将良好的术式提供给临床治疗,改善患者预后。 方法 选取2014年2月—2016年1月在蚌埠市第三人民医院妇科接受子宫切除手术治疗的患者48例作为研究对象,将其分为2组,对照组32例,实施阴式子宫切除术;观察组16例,实施腹腔镜辅助阴式子宫切除术。对2组患者的临床资料进行回顾性分析,比较2组的术中出血量、术后排气时间、术后住院日及术后并发症的发生率。 结果 观察组手术时间长于对照组(P<0.05),与术中需建立CO2气腹,盆腔粘连者多,手术难度大以及对腹腔镜器械不熟练有关。但实验组术中出血量、术后排气时间、术后住院日及术后并发症的发生率明显低于对照组,差异有统计学意义(P<0.05)。 结论 腹腔镜辅助阴式子宫切除术是妇科微创手术,术中视野清晰,可发现并处理盆腔内其他病变,出血少、恢复快、住院时间短、并发症少、安全性高。与阴式子宫切除术相比较,采用腹腔镜辅助阴式子宫切除术治疗方法的临床实际效果显著,是临床实施子宫切除的可靠选择,值得临床推广应用。
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关键词:
- 腹腔镜辅助阴式子宫切除术 /
- 阴式子宫切除术 /
- 临床疗效
Abstract: Objective To compare the clinical efficacy of laparoscopic assisted vaginal hysterectomy(LAVH) and vaginal hysterectomy,and to choose best surgical method for improving the prognosis of patients. Methods From February,2014 to January,2016,forty-eight patients with gynecologic disease undergoing hysterectomy were divided into two groups.The control group(32 cases) received vaginal hysterectomy,while the experimental group(16 cases) received LAVH.The clinical data of the two groups were analyzed retrospectively.The clinical curative effect of both groups was observed.The operational time,bleeding amount,postoperative anal exhaust time,postoperative hospital stays and the incidence of complications were compared between the two groups. Results The operational time in the experimental group was (130.00±32.96) min,which was longer than (81.72±28.67) min in the control group,that related to the establishment of carbon dioxide pneumoperitoneum,serious pelvic adherence,surgical difficulty,and lack of skills by laparoscopy.But the bleeding amount,postoperative anal exhaust time and postoperative hospital stays in the experimental group[(143.75±93.83) ml,(30.06±4.11) h,(5.06±1.24) d] was better than that of the control group[(214.69±68.81) ml,(44.84±5.51) h,(6.16±0.63) d],and the incidence of complications(6.25%) in the experimental group was significantly lower than of the control group(40.63%),the differences were significant(P<0.05). Conclusion The LAVH belongs to minimally invasive operation.It has limpid visual field,can find and deal with other pathological changes in pelvic cavity.It is worthy of clinical application with less blood loss,quick recovery,short hospitalization time,fewer complications and higher safely compared with the vaginal hysterectomy.In clinical practice of hysterectomy,the clinical effect of LAVH treatment compared with vaginal hysterectomy is significant,and it is a reliable clinical implementation of hysterectomy.
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