全子宫切除不同术式的临床分析

发布时间：2018-06-05 09:04

本文选题：全子宫切除术 + 腹腔镜辅助下全子宫切除术　；参考：《山东大学》2014年硕士论文

【摘要】：目的：通过对枣庄市妇幼保健院全子宫切除术不同术式进行比较,来探讨各种全子宫切除术式的优劣,指导临床中更多需要切除子宫的患者选择适宜的手术方式。方法：按照一定的入选标准对枣庄市妇幼保健医院2012年6月-2013年8月行全子宫切除术的患者的病例进行筛选,采用回顾性分析方法,分析比较170例行全子宫切除术的病例,其中腹腔镜辅助下阴式子宫切除术30例(LAVH组)、腹腔镜下全子宫切除术60例(TLH组)、经阴道全子宫切除术35例(TVH组)、经腹全子宫切除术45例(TAH组),就其手术时间、术中出血、术后镇痛、术后排气时间、住院天数、住院费用进行比较。所有入选病例均排除内、外科疾病,术前各项检查指标正常,无重要脏器损伤,可耐受手术。可疑有内膜病变的患者术前均行诊刮术排除恶性变可能。结果：LAVH组及TLH组患者的平均手术时间明显长于其他两组(P0.05),术中出血量各组比较均无明显差异(P0.05),TAH组术后肛门排气时间、住院时间均明显长于LAVH组、TLH组及TVH组,且差异有统计学意义(P0.01),住院费用TAH组、TVH组均低于LAVH组及TLH组(P0.01)；TAH组术后用镇痛剂均高于其他3组(P0.05)。结论：经阴道全子宫切除术和腹腔镜下全子宫切除术均具有手术创伤小、出血少、术后痛苦轻、住院时间短、恢复快等优点,在严格掌握手术适应症情况下,值得推广应用。
[Abstract]:Objective: to explore the advantages and disadvantages of total hysterectomy in Zaozhuang Maternal and Child Health Care Hospital and to guide more patients who need hysterectomy to choose suitable operation methods. Methods: according to the selected criteria, the patients who underwent total hysterectomy in Zaozhuang Maternal and Child Health Hospital from June 2012 to August 2013 were selected, and 170 cases of total hysterectomy were analyzed and compared by retrospective analysis. Among them, 30 cases underwent laparoscopic assisted vaginal hysterectomy (LAVH group), 60 cases underwent laparoscopic hysterectomy (TLH group), 35 cases transvaginal hysterectomy (TVH group) and 45 cases abdominal hysterectomy (TAH group). Postoperative analgesia, postoperative exhaust time, hospital stay, hospitalization expenses were compared. All patients were excluded, surgical diseases, preoperative indicators were normal, no major organ injury, can tolerate surgery. All patients with suspected intimal lesions underwent curettage before operation to eliminate the possibility of malignancy. Results the mean operative time of the patients in the two groups was significantly longer than that in the other two groups. There was no significant difference in the volume of blood loss between the two groups. There was no significant difference between the two groups in the postoperative anal exhaust time and the length of stay in the LAVH group. The hospitalization time was significantly longer than that in the LAVH group and the TVH group. The difference was statistically significant (P 0.01). The cost of hospitalization in TAH group was lower than that in LAVH group and TLH group (P 0.01). The postoperative analgesics in TAH group were higher than those in other three groups (P 0.05). Conclusion: transvaginal hysterectomy and laparoscopic hysterectomy have the advantages of less trauma, less bleeding, less postoperative pain, shorter hospital stay and faster recovery.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R713.42

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