改良腹腔镜下大子宫切除术48例临床观察.docVIP

改良腹腔镜下大子宫切除术48例临床观察 　　[摘要]目的 探讨改良腹腔镜下大子宫切除术的临床效果。方法 回顾性分析108例2013年1月～2015年1月在我院行大子宫（子宫12～16孕周大小）切除术患者的临床资料，其中行传统经腹子宫切除术60例为对照组，行改良腹腔镜下大子宫切除术48例为研究组，比较两组术中、术后情况。结果 两组手术均顺利完成，均无严重并发症发生。研究组手术时间、肛门排气时间、术后发热时间及住院时间均显著短于对照组，术中出血量少于对照组，[（129.5±19.6）min vs （146.8±41.4）min，（32.7±4.8）h vs （39.8±3.5）h，（1.7±0.4）d vs （2.0±0.4）d，（5.6±0.7）d vs （8.2±0.8）d，（139.8±45.5）ml vs （189.2±63.5）ml]差异有统计学意义（P0.05）。两组随访3～12个月，均无严重并发症发生。结论 改良腹腔镜下大子宫切除术，与经腹子宫切除术相比，具有创伤小、恢复快、住院时间短等优点，是安全、可行的，未增加手术危险性和手术并发症。 　　[关键词]全子宫切除术；腹腔镜；大子宫；临床效果 　　[中图分类号] R713.4+2 [文献标识码] A [文章编号] 1674-4721（2016）10（b）-0085-03 　　[Abstract]Objective To investigate the clinical effect of modified laparoscopic hysterectomy.Methods Retrospective analysis was conducted on the clinical data of 108 cases of hysterectomy performed during the period of January 2013 to January 2015，including 48 patients with modified laparoscopic hysterectomy in observation group and 60 patients of total abdominal hysterectomy in control group.The operation situation and postoperative situation were compared between the two groups.Results The procedures were completed in all the 108 patients with no postoperative complications occurred.The operation time，anal exhaust time，the time of postoperative fever，average days of hospital stay were significantly shorter than those in the control group，bleeding amount was less than that of control group[（129.5±19.6）min vs （146.8±41.4）min，（32.7±4.8）h vs （39.8±3.5）h，（1.7±0.4）d vs （2.0±0.4）d，（5.6±0.7）d vs（8.2±0.8）d，（139.8±45.5）ml vs （189.2±63.5）ml]，with statistical difference（P0.05）.The two groups were followed up for 3 to 12 months， there were no serious complicatiors.Conclusion Compared with total abdominal hysterectomy，modified laparoscopic hysterectomy has the advantages of milders trauma，quicker recovery，shorter hospital staym，and is safe and feasible for patients with large uterus and does not increase the risk of operation and complications. 　　[Key words]Hysterectomy；Laparoscopic；Large uterus；Clinical