4种全子宫切除术式的临床效果比较

    Clinical effect of four kinds of hysterectomy

    • 摘要: 目的:比较4种不同途径全子宫切除术的临床效果,探讨全子宫切除术的适合途径。方法:回顾性分析非脱垂子宫良性病变行腹腔镜下全子宫切除术(TLH组)36例、经全子宫切除术(TAH组)41例、经阴道全子宫切除术(TVH组)40例和腹腔镜辅助阴式子宫切除术(LAVH组)42例的临床资料,对4种术式的手术时间、术中出血量、术后恢复时间、术后并发症的发生率、使用抗生素时间、住院费用、住院时间等进行比较。结果:4种不同途径全子宫切除术的手术时间差异有统计学意义(P0.01),术中出血量差异无统计学意义(P0.05);患者术后肛门排气时间、下床活动时间、体温恢复正常时间、住院时间、使用抗生素时间及术后疼痛程度TAH组均显著长/重于TVH组、LAVH组及TLH组(P0.01),住院费用TAH组、TVH组均低于LAVH组及TLH组(P0.01)。结论:4种术式均为安全可行的,各有优缺点,TLH有望成为子宫切除术的趋势,应根据患者的情况及术者的熟练程度选择具体的方式。

       

      Abstract: Objective: To compare the clinical effects of four kinds of hysterectomy and investigate the available way for hysterectomy.Methods: The clinical data of 36 cases were treated with total laparoscopic hysterectomy(TLH group),41 cases were treated with transabdominal hysterectomy(TAH group),40 cases were treated with transvaginal hysterectomy(TVH group) and 42 cases were treated with laparoscope assisted vaginal hysterectomy(LAVH group) were retrospectively analysed.The time of operation,recovery,using antibiotics and hospitalization,the intraoperative bleeding loss,the incidence of complications and the hospitalization expenses of all cases were compared.Results: Among the four groups,there were significant difference in the time of operation(P 0.01) and there was no significant difference in the the intraoperative bleeding loss(P 0.05).The time of postoperative anal exhaust,the leaving bed,the body temperature recovery,hospitalization and using anticiotics and the postoperative pain degrees in TAH group were longer and heavier than that in TVH,LAVH and TLH group(P 0.01).The hospitalization expenses of TAH group and TVH group were less than that in LAVH or TLH group(P 0.01).Conclusions: Four kinds of operation are safe and feasible,which have own advantages and disadvantages.TLH can be a majoy way of hysterectomy.Proper mean should be chosed according to patients' physical condition and the operation doctors' skill.

       

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