中国医药
中國醫藥
중국의약
CHINA MEDICINE
2011年
9期
1130-1131
,共2页
子宫切除术%阴式子宫切除术%腹腔镜全子宫切除术
子宮切除術%陰式子宮切除術%腹腔鏡全子宮切除術
자궁절제술%음식자궁절제술%복강경전자궁절제술
Hysterectomy%Transvaginal hysterectomy%Total laparoscopic hysterecotomy
目的 探讨对子宫＞12孕周经腹、阴道、腹腔镜3种不同途径全子宫切除术式的临床选择.方法 回顾性分析对比153例子宫良性病变行子宫切除术式患者[经腹(TAH组)60例,经阴道(TVH组)26例,经腹腔镜(LTH组)67例]3种不同途径全子宫切除患者的病历资料,记录术中出血量、手术时间及术后发热率、排气时间、术后镇痛、术后住院时间和手术并发症发生情况.结果 3组手术时间及术中出血量无统计学意义(P＞0.05);TVH组术后排气时间较其他两组短,与TAH组比较差异有统计学意义[(42±10)h比(49±12)h;P＜0.05],TVH组和LTH组比较差异无统计学意义;术后住院时间TAH组明显长于TVH组和LTH组,差异有统计学意义[(5.6±1.6)d比(4.5±1.5)d、(4.0±1.0)d;P＜0.01];术后发热率TVH组明显高于TAH组和LTH组(30.8%比3.0%、6.7%;P＜0.01);术后镇痛率TAH组明显高于TVH组和LTH组(66.7%比19.2%、8.9%);术后并发症LTH组输尿管损伤1例,TVH组中转开腹1例.结论 LTH作为微创手术,有着传统开腹手术不可比拟的优点,但要严格掌握好手术指征,掌握手术技巧,根据具体情况选择手术方式,尽量避免严重副损伤的发生.LTH和TVH处理＜16孕周大子宫均是安全、可行的.
目的 探討對子宮＞12孕週經腹、陰道、腹腔鏡3種不同途徑全子宮切除術式的臨床選擇.方法 迴顧性分析對比153例子宮良性病變行子宮切除術式患者[經腹(TAH組)60例,經陰道(TVH組)26例,經腹腔鏡(LTH組)67例]3種不同途徑全子宮切除患者的病歷資料,記錄術中齣血量、手術時間及術後髮熱率、排氣時間、術後鎮痛、術後住院時間和手術併髮癥髮生情況.結果 3組手術時間及術中齣血量無統計學意義(P＞0.05);TVH組術後排氣時間較其他兩組短,與TAH組比較差異有統計學意義[(42±10)h比(49±12)h;P＜0.05],TVH組和LTH組比較差異無統計學意義;術後住院時間TAH組明顯長于TVH組和LTH組,差異有統計學意義[(5.6±1.6)d比(4.5±1.5)d、(4.0±1.0)d;P＜0.01];術後髮熱率TVH組明顯高于TAH組和LTH組(30.8%比3.0%、6.7%;P＜0.01);術後鎮痛率TAH組明顯高于TVH組和LTH組(66.7%比19.2%、8.9%);術後併髮癥LTH組輸尿管損傷1例,TVH組中轉開腹1例.結論 LTH作為微創手術,有著傳統開腹手術不可比擬的優點,但要嚴格掌握好手術指徵,掌握手術技巧,根據具體情況選擇手術方式,儘量避免嚴重副損傷的髮生.LTH和TVH處理＜16孕週大子宮均是安全、可行的.
목적 탐토대자궁＞12잉주경복、음도、복강경3충불동도경전자궁절제술식적림상선택.방법 회고성분석대비153례자궁량성병변행자궁절제술식환자[경복(TAH조)60례,경음도(TVH조)26례,경복강경(LTH조)67례]3충불동도경전자궁절제환자적병력자료,기록술중출혈량、수술시간급술후발열솔、배기시간、술후진통、술후주원시간화수술병발증발생정황.결과 3조수술시간급술중출혈량무통계학의의(P＞0.05);TVH조술후배기시간교기타량조단,여TAH조비교차이유통계학의의[(42±10)h비(49±12)h;P＜0.05],TVH조화LTH조비교차이무통계학의의;술후주원시간TAH조명현장우TVH조화LTH조,차이유통계학의의[(5.6±1.6)d비(4.5±1.5)d、(4.0±1.0)d;P＜0.01];술후발열솔TVH조명현고우TAH조화LTH조(30.8%비3.0%、6.7%;P＜0.01);술후진통솔TAH조명현고우TVH조화LTH조(66.7%비19.2%、8.9%);술후병발증LTH조수뇨관손상1례,TVH조중전개복1례.결론 LTH작위미창수술,유착전통개복수술불가비의적우점,단요엄격장악호수술지정,장악수술기교,근거구체정황선택수술방식,진량피면엄중부손상적발생.LTH화TVH처리＜16잉주대자궁균시안전、가행적.
Objective To investigate the clinical choices of three different kinds of complete hysterectomy through belly, vagina and laparoscope to uterus over 12 gestational weeks. Methods General data of 153 complete hysterectomy patients, including 60 cases through belly, 26 cases through vagina and 67 cases through laparoscope,were retrospectively analyzed. Bleeding amount, operation time, postoperative fever rate, exhaust time, postoperative analgesia, hospitalized time and operative complications were observed. Results The biggest uterus removed in transabdominal hysterectomy group was about(14.8 ±2.9) weeks and bigger than the other groups(P ＜0.01 or P ＜0.05). There was no statistical significance of the operation time and the amount of bleeding during operation among the three groups(P ＜0.05). The postoperative exhaust time of Group total vaginal hysterectomy(TVH) was shorter than that of the other two groups (P ＜ 0. 05). The postoperative hospitalized time of Group total abdorminal hysterectomy(TAH) was longer than that of other two groups(P ＜0.01). The postoperative morbidity of Group TVH was higher than that of other two groups(30.8%). The postoperative analgesia of Group TAH was obviously higher than that of other two groups(66.7%). For the postoperative complication, there was one case of ureter injury for Group total laparoscopic hysterectomy (LTH) and one case of open-belly operation for Group TVH. Conclusions As a minimally invasive surgery, TLH has incomparable advantages over traditional open-belly operation, but it needs strict control of operation indication and good operation technology. In order to prevent serious side-injury, we should choose right operation way according to the actual situation. TLH and TVH are safe and practical for the operations of big uterus.
