目的探讨4种全子宫切除术式的临床效果。方法选择患有良性子宫性疾病(非脱垂子宫)有手术指征的患者200例,分别实施4种不同全子宫切除术式,其中腹腔镜下全子宫切除术(LTH)、阴式全子宫切除术(TVH)、腹腔镜辅助下的阴式全子宫切除术(LAVH)和经腹全子宫切除术(TAH)各50例。通过回顾性分析对各组术中出血、手术时间、住院时间、术后发热、术后疼痛时间、术后排气时间、手术并发症以及术后性生活基本满意率等指标进行系统地评价。结果术中出血量TVH组多于其他三组,其中LTH组最少;手术时间LTH组较其他三组最长;LTH组住院时间最短,而TAH组最长;LTH组术后疼痛时间最短,而TAH组最长;LTH组术后排气时间最短,而TAH组最长;四组患者术后发热和手术并发症发生率差异均无统计学意义;四组患者术后性生活满意率不同,其中LTH组最高。结论 LTH术式较其他术式,具有术中出血少、住院时间短、术后疼痛时间短、术后排气快和性生活满意率高的特点。 Objective To investigate the clinical effects of four kinds of hysterectomy. Methods A total of 200 patients with benign uterine disease (non-prolapsed uterus) who had indications for surgery were enrolled in this study. Four different hysterectomies were performed, including laparoscopic total hysterectomy (LTH), vaginal uterus (50 cases) underwent laparoscopic-assisted vaginal hysterectomy (LAVH) and transabdominal total hysterectomy (TAH). We retrospectively analyzed the intraoperative bleeding, operation time, hospital stay, postoperative fever, postoperative pain time, postoperative exhaust time, surgical complications and postoperative basic satisfaction rate of sexual satisfaction and other indicators of systematic evaluation. Results The intraoperative blood loss was more in the TVH group than in the other three groups, of which the LTH group was the least. The LTH group had the longest operation time compared with the other three groups. The LTH group had the shortest hospital stay and the TAH group had the longest. TAH group was the longest; LTH group had the shortest postoperative exhaust time and the TAH group was the longest; There was no significant difference between the four groups in the incidence of postoperative fever and operative complications; the postoperative sexual satisfaction rate was different in the four groups, The highest in LTH group. Conclusion Compared with other surgical procedures, LTH has the characteristics of less intraoperative bleeding, shorter hospital stay, shorter postoperative pain time, faster postoperative exhaust and higher sexual satisfaction.