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目的:探讨腹腔镜子宫切除术的临床效果和应用价值。方法:将720例因子宫病变有子宫切除指征患者随机分成腹腔镜组和开腹组,并按照腹腔镜手术指征选择4种不同的手术方式,对比腹腔镜子宫次全切除术、腹腔镜筋膜内子宫切除术、腹腔镜辅助阴式子宫切除术、全腹腔镜子宫切除术和开腹组间手术成功率、并发症发生率、术中及恢复情况和全身炎症反应综合症方面的差异。结果:腹腔镜四组手术成功率都在95%以上,远大于开腹组手术成功率(87.4%)(P<0.05)。腹腔镜四组并发症发生率远小于开腹组(P<0.05)。腹腔镜四组在手术成功率和并发症发生率方面差异无统计学意义(P>0.05)。腹腔镜四组在手术时间、术中出血量、住院天数及住院费用方面均低于开腹组(P<0.05)。而腹腔镜四组间比较差异均无统计学意义(P>0.05)。腹腔镜四组全身炎症反应综合症发生率和持续时间均低于开腹组(P<0.05),而腹腔镜四组间比较差异则无统计学意义(P>0.05)。结论:腹腔镜子宫切除术临床效果较好,安全有效,创伤小,费用低,适合符合手术指证的患者应用。
Objective: To investigate the clinical effect and application value of laparoscopic hysterectomy. Methods: A total of 720 patients with hysterectomy due to uterine lesions were randomly divided into laparoscopic group and laparotomy group. According to the indications of laparoscopic operation, 4 different surgical methods were selected, and compared with laparoscopic subtotal hysterectomy, Fascia hysterectomy, laparoscopic assisted vaginal hysterectomy, total laparoscopic hysterectomy and laparotomy success rates, complications, intraoperative and recovery, and systemic inflammatory response syndrome differences . Results: The success rate of laparoscopic surgery in all four groups was above 95%, much higher than that of laparotomy group (87.4%) (P <0.05). The incidence of complications in laparoscopic group four was much less than that in laparotomy group (P <0.05). There was no significant difference in laparoscopic operation success rate and complication rate between the four groups (P> 0.05). Laparoscopy in the four groups in the operation time, blood loss, hospital stay and hospital costs were lower than the open group (P <0.05). There was no significant difference between the four groups in laparoscopy (P> 0.05). The incidence and duration of systemic inflammatory response syndrome in laparoscopic group were lower than those in laparotomy group (P <0.05), but no significant difference was found in laparoscopic group (P> 0.05). Conclusion: Laparoscopic hysterectomy has good clinical effect, safe and effective, small trauma, low cost, suitable for patients with surgical indications.