CAJ | 학술논문

目的：探讨腹腔镜下全子宫切除(total laparoscopic hysterectomy,TLH)术中子宫血管缝扎的疗效、安全性以及临床应用价值。方法将78例行TLH患者随机分成子宫血管缝扎组(n=26)、子宫动脉游离结扎组(n=26)和子宫动脉电凝组(n=26)，比较三组术中手术时间、出血量以及术后病率等情况。结果78例均在腹腔镜下完成手术，术后无1例并发症发生。子宫血管缝扎组在手术时间、出血量和术后病率等方面与子宫动脉游离结扎组相比，差异无统计学意义(>0.05)；子宫血管缝扎组在手术时间和术后病率等方面与子宫动脉电凝组相比差异亦无统计学意义(>0.05)，但出血量较后者明显减少，差异有统计学意义(<0.05)。结论子宫血管缝扎应用于TLH，有效阻断了子宫血供，减少了术中出血量，其疗效确切可靠，在TLH中具有较高的临床应用价值，可作为一种可行的手术方式在基层医院推广应用。
목적：탐토복강경하전자궁절제(total laparoscopic hysterectomy,TLH)술중자궁혈관봉찰적료효、안전성이급림상응용개치。방법장78례행TLH환자수궤분성자궁혈관봉찰조(n=26)、자궁동맥유리결찰조(n=26)화자궁동맥전응조(n=26)，비교삼조술중수술시간、출혈량이급술후병솔등정황。결과78례균재복강경하완성수술，술후무1례병발증발생。자궁혈관봉찰조재수술시간、출혈량화술후병솔등방면여자궁동맥유리결찰조상비，차이무통계학의의(>0.05)；자궁혈관봉찰조재수술시간화술후병솔등방면여자궁동맥전응조상비차이역무통계학의의(>0.05)，단출혈량교후자명현감소，차이유통계학의의(<0.05)。결론자궁혈관봉찰응용우TLH，유효조단료자궁혈공，감소료술중출혈량，기료효학절가고，재TLH중구유교고적림상응용개치，가작위일충가행적수술방식재기층의원추엄응용。
Objective To explore the ef ects,safety and clinical values of uterine vessels suturing with total laparoscopic hysterectomy.Methods 78 patients with total laparoscopic hysterectomy were randomly divided into three groups of uterine vessels suturing group,uterine artery dissociation group and uterine artery electro-coagulation group with 26 cases in each.Compared the three groups patients' dif erence between operative time,blood loss and post-operative morbidity.Results The TLH was completed in al the 78 patients without copmlication after operation.The operation time,the volume of blood loss and post-operative morbidity no significant dif erence between the uterine vessels suturing group and uterine artery dissociation group ( >0.05).The uterine vessels suturing group showed no significant dif erence to uterine artery electro-coagulation group on operation time and post-operative morbidity ( >0.05),yet less blood loss ( <0.05).Conclusion Total laparoscopic hysterectomy with suturing of uterine vessel could block the blood supply to the uterus ef ectively and reduce blood loss during operation,which was a safe and easible. Suturing of uterine vessel had a higher clinical value in TLH.The procedure was worth being widely used in primary hospitals.