腹腔镜全子宫切除术与经腹全子宫切除术治疗大子宫的对照研究.doc

腹腔镜全子宫切除术与经腹全子宫切除术治疗大子宫的对照研究 李建超 潍坊医学院附属医院妇科 摘要:目的　比较腹腔镜全子宫切除术(TLH)和经腹全子宫切除术(TAH)治疗大子宫的临床疗效,为大子宫肌瘤的术式选择提供指导。方法　选取2007年10月—2008年5月间因子宫肌瘤(子宫如孕12周)行全子宫切除的120例患者,其中60例行TAH,60例行TLH,两组病例术前一般情况相似。比较两组手术时间、术后抗生素应用时间、术后住院天数、术中出血量、术后镇痛与否等指标。结果　TLH组抗生素使用时间及术后住院时间较TAH组短;术中出血量较TAH组少;术后疼痛较TAH组轻。两组术式在术后并发症方面无明显差异,但TLH组手术时间较TAH组长。结论　TLH行大子宫切除,是一种安全、疗效确切的手术方式,同时体现了创伤小、恢复快的优点。 关键词:腹腔镜;子宫切除术;大子宫 The Comparing study of Total Laparoscopic Hysterectomy and Total Abdominal Hysterectomy for Treatment of Large Uterus L iJianChao (Department of Gynaecology Affiliated Hospital of Wei Fang Medical College ) Abstract:Objective To compare the clinical results between laparoscopic hysterectomy(TLH)and total abdominal hysterectomy(TAH)in order to provide valuable information for choosing correct treatment of large uterus.Methods One hundred and twenty patients with large uterus were collected from Oct 2007 to May 2008.They were divided into two groups,ie.TLH group(n=60)and TAH group(n=60).Some indexes were recorded,such as duration of operation,antibiotic administration and hospitalization,as well as bleeding volume during operation,and postoperative paregoric administration .The data was analyzed by statistical means. Results　There were significant differences between the two groups in the duration of antibiotic administration(TLH 4.8±0.7,TAH 7.6±1.1 days)and hospitalization(TLH 5.5±0.9,TAH 8.5±1.2 days),and in po stoperative paregoric administration and bleeding volume during operation.Better outcomes were found in TLH group.Conclusion Total Laparoscopic hysterectomy is a safe and effective operation method to large uterus,which possess the virtue of less injurey and sooner recovery. Key words:laparoscope;hysterectom y;large uterus 腹腔镜全子宫切除术(TLH)是指经腹腔镜将子宫完全切除,子宫经阴道取出,经腹腔镜下或经阴道缝合阴道残端的术式[1]。2007年10月—2008年5月我院共完成TLH手术下大子宫(子宫孕12周)60例,选取同期腹式子宫全切(TAH)大子宫(子宫如孕12周)60例。通过对两种术式的配对研究,在手术创伤、治疗效果等方面进行比较,探讨TLH在大子宫切除中的临床应用价值。 1资料及方法 1.1　病例选择　所选病例均术前常规行宫颈细胞学检查以排除宫颈CIN,对合并月经异常或不规则阴道出血者行分段诊刮术或宫腔镜检查,