【摘要】 目的:比较3种不同途径全子宫切除术的临床效果,探讨全子宫切除术的适合途径.方法:回顾性分析非脱垂子宫良性病变行腹腔镜下全子宫切除(TLH)497例、开腹全子宫切除(TAH)425例、经阴道全子宫切除(TVH)231例的临床资料.患者对手术时间、术中出血量、术后恢复时间、术后并发症的发生率、性生活满意度、住院费用、住院时间等临床结果进行比较分析.结果:3种不同途径全子宫切除术的手术时间差异无显著性;术中出血量TLH组明显小于TAH组及TVH组,差异具有统计学意义(P<0.05).而TAH组与TVH组间差异无显著性.术后疼痛程度TAH组显著高于TLH组及TVH组,差异具有统计学意义(P<0.05),而TVH组术后疼痛程度略高于TLH组,两者差异不显著.术后并发症发生率TLH组及TVH组均低于TAH组(P<0.05),而TLH组及TVH组组间差异不显著.使用抗生素时间TLH组及TVH组明显短于TAH组(P<0.05),而TLH组及TVH组组间差异不显著.结论:TLH及TVH2种术式创伤小、恢复快、住院时间短、并发症少,是全子宫切除手术较为理想的途径.更多还原

【Abstract】 AIM:To compare different approaches of hysterectomy by reviewing the clinical results of three kinds of hysterectomy.METHODS:A retrospective analysis was conducted in 497 cases of total laparoscopical hysterectomy(TLH),425 cases of trans-abdominal hysterectomy(TAH) and 231 cases of trans-vaginal hysterectomy(TVH) performed in Shaanxi Mother and Children’s Hospital from January 2004 to 2009.Factors including duration of operation,intra-operative blood loss,postoperative pain,recovery time,incidence of complications,sexual satisfaction and hospital expenses were compared.RESULTS:No significant difference between the three kinds of hysterectomy was observed in the duration of operation.The intra-operative blood loss was significantly less in TLH compared with that in TAH and TVH(P<0.05),but no significant difference was observed between TAH and TVH.Postoperative pain was most severe in TAH compared with that TVH and TLH(P<0.05),and postoperative pain in TVH was only slightly worse than that in TLH.The incidence of postoperative complications was significantly lower in TLH and TVH,compared with that in TAH(P<0.05),and no significant difference was found between TLH and TVH.The duration of antibiotic administration in TLH and TVH was significantly shorter than that in TAH(P<0.05) and no significant difference was observed between the other two approaches.CONCLUSION:Trans-vaginal hysterectomy and total laparoscopical hysterectomy are the two optimal approaches to hysterectomy thanks to their minimum wounds,quick recovery,short hospital time and fewer complications.更多还原