腹腔镜下大子宫全切除术168例临床分析

发布时间：2018-02-17 08:43

本文关键词： 腹腔镜下子宫全切除术适应证并发症　出处：《实用妇产科杂志》2015年08期 　论文类型：期刊论文

【摘要】：目的:探讨腹腔镜下大子宫全切除术的最佳适应证、效果、安全性及手术操作技巧。方法:选择我院2009年1月至2013年1月收治的行大子宫全切除术的患者236例,其中168例行腹腔镜下子宫全切除术(TLH组),68例行开腹子宫全切除术(TAH组),比较两种手术术中、术后情况及手术适应证。结果:子宫大小在12~14周者TLH组明显多于TAH组,分别占45.2%与20.6%(P0.01)。两组手术时间比较差异无统计学意义(P0.05),术中出血量TAH组(166.2±68.6 ml)多于TLH组(102.6±48.6 ml),手术近期并发症腹部切口感染TAH组(5.9%)多于TLH组(0.6%),两组比较差异均有统计学意义(P0.05)。术后病理检查均为良性病变,4例富于细胞型平滑肌瘤经随访1~5年均无复发。结论:腹腔镜下大子宫全切除术在选择合适的置镜位置,在镜下离断圆韧带、卵巢固有韧带及子宫动脉上行支后,及时移除影响深部操作的大子宫体的情况下是安全、可行的,不会增加手术危险性和手术并发症,但对术者除要求具备丰富的镜下手术经验外,还要对患者子宫大小和肌瘤的性质进行综合评估。
[Abstract]:Objective: To investigate the effect of laparoscopic hysterectomy indication, effect, safety and operation skills. Methods: in our hospital from January 2009 to January 2013 were for 236 cases of patients with uterine total resection of the uterus, 168 cases underwent laparoscopic hysterectomy (TLH group), 68 cases of abdominal total hysterectomy excision (TAH group), compared two kinds of surgery, and surgical postoperative syndrome. Results: the uterine size at 12~14 weeks in TLH group was significantly higher than that in TAH group, which accounted for 45.2% and 20.6% (P0.01). The two groups had no statistically significant difference in operation time (P0.05), the amount of bleeding in TAH group in (166.2 + 68.6 ml) than that of group TLH (102.6 + 48.6 ml), surgical complications of abdominal incision infection in TAH group (5.9%) than that of group TLH (0.6%), with significant differences between the two groups (P0.05). The postoperative pathological examination were benign lesions, 4 cases of cellular leiomyoma by with the Visit 1~5 years showed no recurrence. Conclusion: laparoscopic hysterectomy in the appropriate position of a mirror, in the mirror under the interruption of the round ligament, ovarian ligament and natural ascending uterine artery, promptly remove effect of sub palace deep under the operation is safe, feasible, will not increase surgical risk and surgical complications, but for patients who have experienced surgery in addition to the requirements under the microscope, but also the nature of the patients with uterine fibroids and size were evaluated.

【作者单位】：解放军260医院;
【分类号】：R713.4

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