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目的探讨腹腔镜辅助阴式子宫全切术的特点及优势。方法回顾性分析2009年10月至2011年12月行子宫全切术子宫良性病变患者56例的临床资料,其中行阴式子宫全切术(TVH)患者26例,行腹腔镜辅助阴式子宫全切术(LAVH)患者30例,两组基线资料均衡。比较分析两组的临床指标、治疗效果及并发症的发生情况。结果两组手术顺利,术后住院天数和术中术后并发症差异无统计学意义;LAVH组手术时间(124±20)min,明显大于TVH组(98±25)min(P<0.01);LAVH组出血量(158±62)ml显著低于TVH组出血量(236±55)ml(P<0.01)。TVH术中同时行附件或输卵管切除术2例(7.7%);LAVH组在术中同时处理其他病变12例(40.0%),两组比较差异有统计学意义(P<0.01)。两组术中术后并发症轻微,无严重并发症发生。结论两组均为微创手术且疗效相当,但与TVH相比,LAVH手术视野更开阔,可同期探查腹腔其他病变,使手术适应证更宽。
Objective To investigate the characteristics and advantages of laparoscopic assisted vaginal hysterectomy. Methods The clinical data of 56 patients with uterine benign lesions underwent hysterectomy from October 2009 to December 2011 were analyzed retrospectively. Among them, 26 cases underwent vaginal hysterectomy (TVH) and laparoscopic assisted vaginal uterus Thirty patients underwent total excision (LAVH). The baseline data of the two groups were balanced. Comparative analysis of two groups of clinical indicators, the treatment effect and the incidence of complications. Results There was no significant difference between the two groups in the number of days of hospitalization and postoperative complications. The operative time (124 ± 20) min in LAVH group was significantly higher than that in TVH group (98 ± 25) min (P <0.01). The amount of bleeding in LAVH group (158 ± 62) ml was significantly lower than that in TVH group (236 ± 55) ml (P <0.01). There were 2 cases (7.7%) of simultaneous TVH operation with attachments or tubal resection, and 12 cases (40.0%) of other lesion treated simultaneously in LAVH group. There was significant difference between the two groups (P <0.01). Postoperative complications in both groups were mild and no serious complications occurred. Conclusions Both groups are minimally invasive and have similar curative effect. However, compared with TVH, the visual field of LAVH is more open, and other intraperitoneal lesions can be explored in the same period, which makes the surgical indications wider.