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目的探讨腹腔镜下全子宫切除术对患者的治疗效果及胃肠道功能恢复、盆底功能的影响。方法选取2015年1月-2016年8月在该院择期行全子宫切除手术的94例患者进行回顾性分析,根据手术方式分为腹腔镜组48例、开腹组46例,对比两组围手术期指标、术后胃肠道功能恢复情况、盆底功能变化。结果腹腔镜组的手术出血量、术后下床活动时间、留置导尿管时间、住院时间均低于开腹组,差异有统计学意义(t=13.237、3.841、4.723、6.08,均P<0.05),两组患者的手术时间差异无统计学意义(t=0.87,P>0.05);腹腔镜组的肠鸣音恢复时间、肛门排气时间、排便时间、术后进食时间均低于开腹组,差异有统计学意义(t=2.163、3.314、3.011、4.671,均P<0.05);腹腔镜组的手术并发症发生率8.33%,开腹组的手术并发症发生率17.39%,两组并发症率差异无统计学意义(χ2=1.731,P>0.05);术后3个月,腹腔镜组的尿失禁发生率8.33%,开腹组的尿失禁发生率17.39%,两组尿失禁发生率差异无统计学意义(χ2=1.731,P>0.05)。结论腹腔镜下全子宫切除术相对于传统开腹手术具有手术创伤小、胃肠道功能恢复快的优势,不会增加盆底功能障碍及手术并发症的发生率。
Objective To investigate the effect of laparoscopic hysterectomy on the treatment of patients and gastrointestinal function recovery, pelvic floor function. Methods Ninety-four patients undergoing elective hysterectomy in our hospital from January 2015 to August 2016 were retrospectively analyzed. According to the surgical methods, 48 cases were divided into laparoscopic group and open group, 46 cases were compared. Surgical indicators, postoperative gastrointestinal function recovery, pelvic floor function changes. Results The amount of operation bleeding, postoperative ambulation time, indwelling catheterization time and hospitalization time in laparoscopic group were all lower than those in open group (t = 13.237, 3.841, 4.723, 6.08, P < 0.05). There was no significant difference in operative time between the two groups (t = 0.87, P> 0.05). The bowel recovery time, anal exhaust time, defecation time and postoperative eating time in laparoscopic group were all lower than those in open (T = 2.163,3.314,3.011,4.671, all P <0.05). The incidence of complications in the laparoscopic group was 8.33%, the incidence of complications in the laparotomy group was 17.39%, the difference was statistically significant The incidence of urinary incontinence in the laparoscopic group was 8.33% at 3 months after operation, and the incidence of urinary incontinence in the open group was 17.39%. The urinary incontinence rates in both groups were significantly higher than those in the open group (χ2 = 1.731, P> 0.05) The incidence of incontinence had no significant difference (χ2 = 1.731, P> 0.05). Conclusions Laparoscopic hysterectomy has the advantages of less operation trauma and faster recovery of gastrointestinal function than traditional laparotomy, and does not increase the incidence of pelvic floor dysfunction and surgical complications.