腹式与阴式子宫切除的临床效果比较.doc

作者基本情况，资料时间 腹式与阴式子宫切除的临床效果比较 xx 安阳市妇幼保健院 妇产科 安阳市 455000 摘要 目的 探讨腹式子宫切除术（TAH）与阴式子宫切除术（TVH）的临床应用价值。方法 回顾性分析2007年1月-2007年12月比较TAH50例、TVH 50例的临床资料，包括手术时间，术中出血量，术中、术后并发症、术后肛门排气时间、下床活动时间、术后镇痛剂使用率和术后住院日。结果 手术时间、术中出血量、术后肛门排气时间、下床活动时间、术后住院日，两组比较，差异有显著性（p 0.01），术后镇痛剂使用率两组比较，差异无显著性（p 0.01）。结论 与腹式子宫切除术相比较，阴式子宫切除术符合微创手术原则，具有手术时间短、对病人损伤小、术后恢复快，术后住院时间短的优点。 关键词：腹式子宫切除术 阴式子宫切除术 中图分类号：R713.42 文献标示码：B 文章编号： Comparison of two operations for hysterectomy Li Zhiwei Department of Obstetrics and Gynecology,the Maternity Childcare Hospital of Anyang city, Anyang 455000 Key Words total abdominal hysterectomy;vaginal hysterectomy Abstract Objective To compare the clinical value of total abdominal hysterectomy(TAH),Transvaginal hysterectomy(TVH).Method Intraoperative and postoperative characteristics of 50 patients undergoing TAH,50undergoing TVH were analyzed retrospectively,including operative time,intraoperative blood loss,complications,the first time to getting out of bed, recovery of bowel movement ,the number of patients with a need for analgesics and postoperative hospitalizing days.Result Mean time of surgery and the first time to getting out of bed were significantly longer for TAH than TVH （p 0.01）.Blood loss in operation was significantly smaller for TAH than TVH （p 0.01）.Mean postoperative stay in hospital and recovery of bowel movement were significantly longer for TAH than TVH（p 0.01）.There was no significant difference in the number of patients with a need for analgesics（p0.05）.Conclusion TVH is not only an operation need less time,but also offers minimal invasion,shorter recovery time and lower cost. 随着微创技术的不断发展，阴式子宫切除术日趋广泛，为评价其优缺点，我们对50例阴式子宫切除术临床资料进行回顾性分析，并与50例腹式子宫切除术进行比较，报道如下。 1资料及方法 1.1 研究对象：2007年1月-2007年12月间我院收治的因各种子宫良性病变而行子宫切除术100例，无心、肝、肾、肺等疾病，无手术史，其中开腹子宫切除术（total abdominal hysterectomy，TAH）50例，经阴道子宫切除术（vaginal hysterectomy，TVH）50例，对两组患者的临床特征和手术指征进行比较，无显著性差异。术后给予预防性抗生素治疗3～5天。手术时间、术中出血量、下床活动时间、术后肛门排气时间、术后需要镇痛药人数、术后住院时间等进行比较。 1.2手术方法 1.2.1VH 腰硬联合麻醉，取膀胱截