不同子宫切除术式的临床疗效分析

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1、不同子宫切除术式的临床疗效分析【摘要】目的探讨腹腔镜下不同子宫切除术的临床疗效。方法回顾性分析2000-2004年78例患者分别行腹腔镜下子宫次全切除术(LSH)、改良筋膜内子宫全切术(MCISH)或腹腔镜辅助的阴式子宫切除术(LAVH),比较三组患者术中、术后情况。结果三组患者的手术时间、术后疼痛发生率、术后使用抗生素时间、体温升高、肛门排气时间、术后下床活动时间和术后住院时间差异均无显著性，手术时间、术中出血量LAVH组较LSH、MCISH组显著增加，LAVH、MCISH组术后性生活恢复时间均较LSH组延长。三组均无手术并发症发生。结论腹腔镜子宫全切术具有创

2、伤小，腹腔内环境干扰小，恢复快等优点。腹腔镜下子宫次全切除术、筋膜内子宫切除术和腹腔镜辅助阴式子宫切除术都是安全可行的，三种手术方式各有其优缺点，术式选择应根据设备的情况、患者情况及术者对手术方式的掌握程度來定。【关键词】腹腔镜；子宫切除；子宫AnalysisonclinicaleffectofdifferentapproachroutesinhysterectomyJIANGXiao-rongJANMan-xia,MAHong-liu.DepartmentofObstetricsandGynecology,ThePeoplesHospitalofDianjia

3、ng,Dianjiang408300,China[Abstract]ObjectiveToinvestigatetheclinicaleffectofdifferentmethodsoflaparoscopichysterectomy.Methods78casesacceptedclassicintrafascialsupracervicalhysterectomy(MCISH)orlaparoscopicassistedvaginalhysterectomy(LAVH)orlaparoscopicsupracervicalhysterectomy(LSH)we

4、restudiedretrospectively.Thesituationwerecomparedbetweenoperationandpostoperation.ResultsTherewerenosignificantdiffereneebetweentheoperatingtime,postoperativepainincidenee,usingantibiotictime,temperature,timeofpassageofgasbyanus,postoperativetimeofoutof-bedactivityandhospitalizationt

5、ime.WhileestimatedbloodlossofcasesofLAVHweresignificantlymorethanthoseofcasesofLSHandMCISHandtimeofrecoversexualincasesofLAVHandMCISHweresign汗icantIongerthancasesofLSH.Nocomplicationwashappened.ConclusionThewoundoflaparoscopicallyhysterectomyissmall;theinflueneeoninternalenvironmenti

6、nabdominalcavityislittleandtherecoveryisquick.LSH,MCISHandLAVHareallsafeandreliableandwithitselfbehaviors.Theoperationwaysshouldbeselectedontheconditionofequipmentandpatient'sconditionandoperatingpersorfsskill.[Keywords】celioscopy;hysterectomy;uterus随着微创手术技术的发展，用腹腔镜代替开腹手术己成为必然趋势。我院20

7、00-2004年分别用腹腔镜辅助的阴式子宫切除术(LAVH)、腹腔镜筋膜内子宫全切除术(CISH)和腹腔镜子宫次全切除术(LSH)三种方法进行腹腔镜下子宫切除术[其中用改良筋膜内子宫切除术(MCISH)替代CISH]78例，取得满意疗效，现报告如下。1资料与方法1.1一般资料本组78例，年龄27—57岁，平均43.2岁，均为已婚。病程3个月〜3年，平均6.4个月；其中LAVH19例，MCISH26例，LSH33例。平均年龄：LAVH组为48.2岁，MCISH组40.3岁，LSH组39.3岁，有3例未育(CISH组1例，LSH2例)。三组患者中除LSH组有4例、M

8、CISH组有2例子宫超过