经腹腔镜子宫全切除术的技术改进

发布时间：2019-02-17 18:37

【摘要】：目的 :探讨腹腔镜下子宫全切除术的改良,是否可以有效避免术中输尿管损伤,减少术中出血量,缩短手术时间。方法:分析本院2011年6月~2013年5月间,453例腹腔镜下子宫全切除术患者的临床资料,其中采用常规的腹腔镜下子宫全切除术220例,采用改良的腹腔镜下子宫全切除术233例,比较两组患者的手术时间、术中出血量、术后住院时间、术中术后并发症、肠道恢复时间。结果:研究组和对照组手术时间分别为(71.33±11.09)min和(122.36±15.49)min,术中出血量分别是(31.94±10.26)ml和(173.41±14.40)ml,术后肛门排气时间分别是(30.52±2.09)h和(50.97±6.05)h,两组比较差异均有统计学意义(P0.05)。研究组术中术后并发症发生2例(皮下气肿1例、术后病率1例),对照组术中术后并发症发生8例(术中输尿管损伤4例、术中血管损伤1例、皮下气肿1例、术后病率2例),两组比较差异有统计学意义(P0.05)。结论:改良的腹腔镜下子宫全切术在手术时间、术中出血量、术中术后并发症、术后肠道恢复方面明显优于常规腹腔镜下子宫全切除术,是有效可行的。
[Abstract]:Objective: to investigate whether laparoscopic hysterectomy can effectively avoid ureteral injury, reduce intraoperative bleeding and shorten operative time. Methods: the clinical data of 453 patients undergoing laparoscopic hysterectomy from June 2011 to May 2013 were analyzed. Among them, 220 cases were treated by conventional laparoscopic hysterectomy and 233 cases by modified laparoscopic hysterectomy. The operative time, intraoperative bleeding volume, postoperative hospitalization time, intraoperative complications and intestinal recovery time were compared between the two groups. Results: the operative time of the study group and the control group were (71.33 卤11.09) min and (122.36 卤15.49) min, respectively. The blood loss was (31.94 卤10.26) ml and (173.41 卤14.40) ml, respectively. The postoperative anal exhaust time was (30.52 卤2.09) h and (50.97 卤6.05) h, respectively. The difference between the two groups was statistically significant (P0.05). Complications occurred in 2 cases (1 case of subcutaneous emphysema and 1 case of postoperative disease) in the study group, and 8 cases in the control group (4 cases of intraoperative ureteral injury, 1 case of intraoperative vascular injury, 1 case of subcutaneous emphysema). Postoperative disease rate of 2 cases, the two groups were statistically significant difference (P0.05). Conclusion: the modified laparoscopic total hysterectomy is more effective than conventional laparoscopic hysterectomy in terms of operation time, intraoperative bleeding, postoperative complications and postoperative intestinal recovery.
【作者单位】：淮安市淮阴医院妇科;
【分类号】：R713.42

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