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目的探讨70岁以上老年人因妇科良性疾病行全子宫及双侧附件切除术时选用腹腔镜手术方式的安全性。方法回顾性分析郑州大学第一附属医院2005年1月至2010年12月因妇科良性疾病行全子宫及双侧附件切除术(子宫及阴道脱垂者除外)的70岁及以上患者共170例,比较腹腔镜组(90例)及开腹组(80例)在术前、术中及术后的恢复情况。结果腹腔镜组患者的平均手术时间及术中出血量明显少于开腹组(P<0.05);腹腔镜组患者术后肛门排气时间、术后恢复正常饮食时间、术后下床活动时间、术后抗生素使用时间及术后住院时间优于开腹手术组患者;腹腔镜组患者的住院总花费明显多于开腹组(P<0.05)。结论腹腔镜手术对于70岁及以上老年妇科良性疾病的治疗具有独特优势,疗效肯定,且具有安全性高、创伤小、恢复快等优点。
Objective To investigate the safety of laparoscopic surgery in the treatment of benign gynecological diseases in 70-year-olds with total hysterectomy and bilateral attachment excision. Methods A total of 170 patients aged 70 years and above underwent total hysterectomy and bilateral accessory excision (except uterine and vaginal prolapse) in the First Affiliated Hospital of Zhengzhou University from January 2005 to December 2010. (90 cases) and open group (80 cases) were compared before, during and after operation. Results The average operation time and intraoperative blood loss of patients in laparoscopic group were significantly less than those in open group (P <0.05). The time of postoperative anal exhaust, postoperative recovery of normal diet, postoperative ambulation time , Postoperative antibiotic use time and postoperative hospital stay were superior to those in open surgery group. The total cost of hospitalization in laparoscopic group was significantly more than that in open group (P <0.05). Conclusions Laparoscopic surgery has unique advantages for the treatment of benign gynecological diseases in the elderly aged 70 and above, with definite curative effect and high safety, less trauma and quicker recovery.