CAJ | 학술논문

目的探讨经腹及腹腔镜子宫切除术的术中及术后情况的比较。方法对2011年10月～2012年5月因子宫肌瘤或子宫肌腺症行经腹全子宫切除术（total abdominal hysterectomy，TAH）（53例）、经腹次全子宫切除术（subtotal abdominal hysterectomy，SAH）（20例），及腹腔镜下全子宫切除（laparoscopically total hysterectomy，LTH）（45例）、腹腔镜下次全子宫切除术（laparoscopically subtotal hysterectomy，LSH）（22例）共140例的临床资料做回顾性分析。结果TAH和LTH手术时间、术后疼痛程度评分、肛门排气时间、下床活动时间相比较，差异有显著统计学意义（P＜0.01）。术中出血量两者相比较差异无统计学意义（P＞0.05）。SAH和LSH手术时间、术后疼痛程度评分、肛门排气时间、下床活动时间相比较，差异有显著统计学意义（P＜0.01），术中出血量两者相比较差异无统计学意义（P＞0.05）。但是LSH术后有1例因腹腔出血较多行开腹止血。TAH术后有1例发生膀胱阴道瘘。结论妇科腹腔镜手术较开腹难度大，但有很多优点，所有手术应严格规范仔细操作，避免过度自信，降低并发症的发生。
목적탐토경복급복강경자궁절제술적술중급술후정황적비교。방법대2011년10월～2012년5월인자궁기류혹자궁기선증행경복전자궁절제술（total abdominal hysterectomy，TAH）（53례）、경복차전자궁절제술（subtotal abdominal hysterectomy，SAH）（20례），급복강경하전자궁절제（laparoscopically total hysterectomy，LTH）（45례）、복강경하차전자궁절제술（laparoscopically subtotal hysterectomy，LSH）（22례）공140례적림상자료주회고성분석。결과TAH화LTH수술시간、술후동통정도평분、항문배기시간、하상활동시간상비교，차이유현저통계학의의（P＜0.01）。술중출혈량량자상비교차이무통계학의의（P＞0.05）。SAH화LSH수술시간、술후동통정도평분、항문배기시간、하상활동시간상비교，차이유현저통계학의의（P＜0.01），술중출혈량량자상비교차이무통계학의의（P＞0.05）。단시LSH술후유1례인복강출혈교다행개복지혈。TAH술후유1례발생방광음도루。결론부과복강경수술교개복난도대，단유흔다우점，소유수술응엄격규범자세조작，피면과도자신，강저병발증적발생。
Objective The circumstance of intraoperative and postoperative in different way of hysterectomy were investigated.Methods A retrospective analysis was done on clinical of 140 cases of TAH(53 cases),SAH(20 cases),and LTH(34 cases),LSH(22 cases) because of myoma or adenomyosis from October 2011 to May 2012 in this hospital.Results There have signiifcant difference among the operation time,AFS after operation,the time of passage of gas by anus and out-of-bed activity between TAH and LTH(P<0.01),but has no signiifcant difference in intraoperative bleeding(P>0.05).The same results comes out between SAH and LSH.But one of LSH because of bleeding in abdominal cavity has another operation.There is a vesicovaginal ifstula in the TAH.Conclusion Laparoscopic operation of gynecology has more complication,but it has more merit.Every operation should be managed carefully,avoid over conifdence and decreased the complications.