CAJ | 학술논문

目的：比较阴式子宫切除（ vaginal hysterectomy ，VH）、腹腔镜辅助阴式子宫切除（ laparoscopically assisted vaginal hysterectomy，LAVH）以及腹腔镜子宫切除（total laparoscopic hysterectomy ，TLH）治疗子宫良性疾病的特点。方法回顾性分析我院2011年3月～2013年11月因子宫良性病变行全子宫切除155例资料，由患者选择手术方式，VH组60例，LAVH组50例，TLH组45例。比较3组手术时间、出血量、止痛药的使用以及住院时间的差异。结果手术时间VH组[中位数65（40～85） min]＜LAVH组[90（45～150） min]＜TLH组[120（80～180） min]（χ2＝89．105， P＝0．000）；术中出血量VH组[208（155～241） ml]和TLH组[183（159～220） ml]＜LAVH组[359（316～413） ml]（χ2＝72．609， P＝0．000）；术后应用止痛药LAVH组[2（1～5）支]＜VH组[4（1～8）支]和TLH组[5（3～8）支]（χ2＝59．243， P＝0．000）。术后住院时间3组间差异无显著性（P＞0．05）。结论对于子宫良性病变，VH及LAVH是比较好的子宫切除术式。
목적：비교음식자궁절제（ vaginal hysterectomy ，VH）、복강경보조음식자궁절제（ laparoscopically assisted vaginal hysterectomy，LAVH）이급복강경자궁절제（total laparoscopic hysterectomy ，TLH）치료자궁량성질병적특점。방법회고성분석아원2011년3월～2013년11월인자궁량성병변행전자궁절제155례자료，유환자선택수술방식，VH조60례，LAVH조50례，TLH조45례。비교3조수술시간、출혈량、지통약적사용이급주원시간적차이。결과수술시간VH조[중위수65（40～85） min]＜LAVH조[90（45～150） min]＜TLH조[120（80～180） min]（χ2＝89．105， P＝0．000）；술중출혈량VH조[208（155～241） ml]화TLH조[183（159～220） ml]＜LAVH조[359（316～413） ml]（χ2＝72．609， P＝0．000）；술후응용지통약LAVH조[2（1～5）지]＜VH조[4（1～8）지]화TLH조[5（3～8）지]（χ2＝59．243， P＝0．000）。술후주원시간3조간차이무현저성（P＞0．05）。결론대우자궁량성병변，VH급LAVH시비교호적자궁절제술식。
Objective To compare the characteristics of vaginal hysterectomy ( VH ) , laparoscopically assisted vaginal hysterectomy ( LAVH ) and total laparoscopic hysterectomy ( TLH ) for benign uterine diseases . Methods We retrospectively collected 155 cases of hysterectomy for benign uterine diseases in our hospital during March 2011 to November 2013.The surgical approach was chosen by patients .There were 60 cases of VH, 50 cases of LAVH, and 45 cases of TLH.The operating time, blood loss, consumption of analgesics , and the length of hospital stay were compared among the three groups . Results The median operation time was 65 min (range, 40-85 min) in the VH group, 90 min (range, 45-150 min) in the LAVH group, and 120 min (range, 80-180 min) in the TLH group, with statistically significant difference (χ2 =89.105, P=0.000).The blood loss had no significant difference between the VH group (208 ml, 155-241 ml) and the TLH group (183 ml, 159-220 ml), but significantly less than that in the LAVH group [359 ml (316-413 ml),χ2 =72.609, P=0.000].The consumption of analgesics in the LAVH group (2 doses, 1-5 doses) was significantly less than that in the VH group (4 doses, 1-8 doses) and the TLH group (5 doses, 3-8 doses) (χ2 =59.243, P=0.000).There was no significant difference in postoperative hospital stay among the three groups . Conclusion For benign uterine disease , VH and LAVH are preferential surgical procedures .