摘要
目的探讨3种不同途径子宫切除术的适应证,以提供非脱垂子宫手术的最佳选择。方法回顾性分析我院非脱垂子宫子宫切除术278例患者的临床资料。其中腹式子宫全切除术(TAH)148例,阴式子宫全切除术(TVH)68例,腹腔镜辅助阴式子宫全切除术(LAVH)62例;比较3种手术手术时间、术中出血量、术后肛门排气时间、住院时间、住院费用。结果子宫<2孕月,TVH组手术时间明显短于LAVH组(P<0.01),术中出血量明显少于TAH组(P<0.01)。子宫>2孕月,3组手术时间比较差异无统计学意义,术中出血量LAVH组明显少于TAH组和TVH组(均P<0.01)。3组术后肛门排气时间,TVH组明显短于TAH组和LAVH组(P<0.01)。住院时间、住院货用TVH组明显少于LAVH组(P<0.01),与TAH比较差异无统计学意义(P>0.05)。结论TVH创伤小,恢复快,费用低,但适应于子宫<2孕月、无附件病变、无既往盆腔手术史病例。LAVH扩大了TVH的适应证,但费用高。
Objective To provide the optimal choice of the operation method for patients without uterine prolapse by discussing the indications of three different hysterectomy approaches. Methods A retrospective analysis was made on 278 cases of hysterectomys, 148 cases of total abdominal hysterectomy （ TAH） ,58 of total vaginal hysterectoiny （ TVH ）, and 52 of laparoscopic assisted vaginal hysterectomy （ LAVH ）. The operation duration, introperative bleeding volume, postoperative time of passage of gas by anus, hospitalization duration and cost were compared. Results In the cases who were less than two months of pregnancy,the operation time of the TVH group was significantly shorter than that of LAVH group （ P 〈0.01 ） ,the blood loss of TVH group was significantly less than that of TAH group （ P 〈0.01 ） ;In the cases who were more than two months of pregnancy, the operation time of those three groups had no significant difference, the blood loss of the LAVH was obviously less than that of TAH or TVH group （ P 〈 0.01 ）. The postoperative flatus time of the TVH group was significantly later than that of TAH or LAVH group （ P 〈 0.01 ）. The length of hospital and stay, cost was significantly less in TVH group than those of LAVH group （ P 〈 0. 01 ）, There was no significant difference in the length of stay and cost between TVH and TAH group （ P 〉 0.05 ）. Conclusion The TVH has the advantages of less trauma, quicker recovery and lower costs, but it should be used in the patients with less than 2 months pregnant, no annex diseases and previous history of pelvic surgeries. LAVH expands the indications of the TVH,but the cost is higher.
出处
《中国综合临床》
北大核心
2007年第9期853-854,共2页
Clinical Medicine of China
