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目的:比较3种不同途径子宫切除术的临床效果,探讨子宫切除的理想途径。方法:回顾分析应用腹腔镜辅助阴式子宫切除(LAVH)109例、开腹全子宫切除(TAH)54例、经阴道全子宫切除(TAH)23例的临床资料,对手术时间、术中出血量、肛门排气时间、术后病率、疼痛程度、住院费用等进行比较分析。结果:3种不同途径全子宫切除术的手术时间差异无显著性(P>0.05);TVH手术组术中出血量明显少于LAVH及TAH组,差异有显著性(P<0.05);TVH组术后疼痛程度稍高于LAVH组,差异无显著性(P>0.05);LAVH组及TVH组术后肛门排气时间、术后病率均低于TAH组,差异有显著性(P<0.05);LAVH组与TVH组差异无显著性(P>0.05);LAVH组109例患者均在腹腔镜下完成手术,无中转开腹及严重并发症。结论:LAVH及TVH是需要行子宫切除手术患者的较理想的手术方式,LAVH降低了TVH手术难度,扩大了TVH手术范围,具有创伤小、恢复快、住院时间短、术中术后并发症少等优点,值得在有条件的医院广泛开展。
Objective: To compare the clinical effects of three different ways of hysterectomy and to explore the ideal way of hysterectomy. Methods: The clinical data of 109 cases of laparoscopic assisted vaginal hysterectomy (LAVH), open hysterectomy (TAH) in 54 cases and vaginal hysterectomy (TAH) in 23 cases were analyzed retrospectively. The operative time, intraoperative bleeding Volume, anal exhaust time, postoperative morbidity, pain, hospitalization costs and other comparative analysis. Results: There was no significant difference in operative time among the three different ways of hysterectomy (P> 0.05). The TVH group had less bleeding during operation than LAVH and TAH groups (P <0.05) Postoperative analgesia was slightly higher in the LAVH group than in the LAVH group (P> 0.05). The time of postoperative anal exhaust and the postoperative morbidity in the LAVH and TVH groups were significantly lower than those in the TAH group (P <0.05) ). There was no significant difference between LAVH group and TVH group (P> 0.05). 109 patients in LAVH group underwent laparoscopic surgery without laparotomy and serious complications. Conclusion: LAVH and TVH are the ideal surgical methods for patients undergoing hysterectomy. LAVH reduces the difficulty of TVH operation and enlarges the scope of TVH surgery. It has the advantages of less trauma, faster recovery, shorter hospital stay, less postoperative complications And other advantages, it is worth carrying out a wide range of conditions in the hospital.