CAJ | 학술논문

目的:评价阴式子宫切除术(transvaginal hysterectomy,TVH)、腹腔镜辅助阴式子宫切除术(laparoscopic assisted vaginal hysterectomy,LAVH)、腹腔镜子宫次全切除术(laparoscopic subtotal hysterectomy,LSH)及完全腹腔镜子宫切除术(laparoscopically total hysterectomy,LTH)4种微创手术的价值及手术适应证.方法:回顾分析1 027例患者4种子宫切除术的手术时间、术中出血量、术后康复时间及住院费用.结果:TVH组手术时间、术中出血量、住院费用均优于腹腔镜组(P＜0.01);3组腹腔镜手术中LTH手术时间最长,LSH次之,LAVH最短;LAVH组出血最少,而LSH与LTH差异无统计学意义(P＞0.05);4组术后病率、平均住院时间差异无统计学意义(P＞0.05);TVH组与LSH组术中并发症发生率差异无统计学意义(P＞0.05),2组的并发症均在开展此术式的早期发生.术后并发症发生率LSH组明显高于TVH、LAVH、LTH组(P＜0.01),LTH组高于TVH组(P＜0.01),而与LAVH组差异无统计学意义(P＞0.05),TVH组与LAVH组差异无统计学意义(P＞0.05).结论:4种术式均为微创子宫切除的有效术式,各有利弊;应根据患者的病情及术者技术水平选择术式.
목적:평개음식자궁절제술(transvaginal hysterectomy,TVH)、복강경보조음식자궁절제술(laparoscopic assisted vaginal hysterectomy,LAVH)、복강경자궁차전절제술(laparoscopic subtotal hysterectomy,LSH)급완전복강경자궁절제술(laparoscopically total hysterectomy,LTH)4충미창수술적개치급수술괄응증.방법:회고분석1 027례환자4충자궁절제술적수술시간、술중출혈량、술후강복시간급주원비용.결과:TVH조수술시간、술중출혈량、주원비용균우우복강경조(P＜0.01);3조복강경수술중LTH수술시간최장,LSH차지,LAVH최단;LAVH조출혈최소,이LSH여LTH차이무통계학의의(P＞0.05);4조술후병솔、평균주원시간차이무통계학의의(P＞0.05);TVH조여LSH조술중병발증발생솔차이무통계학의의(P＞0.05),2조적병발증균재개전차술식적조기발생.술후병발증발생솔LSH조명현고우TVH、LAVH、LTH조(P＜0.01),LTH조고우TVH조(P＜0.01),이여LAVH조차이무통계학의의(P＞0.05),TVH조여LAVH조차이무통계학의의(P＞0.05).결론:4충술식균위미창자궁절제적유효술식,각유리폐;응근거환자적병정급술자기술수평선택술식.