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目的:探讨开腹、阴式、腹腔镜辅助阴式子宫全切除术的临床疗效。方法:回顾性分析行子宫全切除术的患者300例,其中腹腔镜辅助阴式子宫全切术(LAVH)101例,阴式子宫全切术(TVH)106例,开腹子宫全切术(TAH)93例,比较3组患者手术时间,出血量,术后病率,肛门排气时间,镇痛数及术后住院时间。结果:TAH、TVH和LAVH组手术时间差异无统计学意义(P>0.05);LAVH与TVH组出血量、术后病率及镇痛数均明显优于TAH,差异均具有统计学意义(P<0.05),且LAVH组术后病率显著优于TVH组(P<0.05)。LAVH与TVH组肛门排气时间和术后住院时间均明显短于TAH组,差异均具有统计学意义(P<0.05)。LAVH组出血量、镇痛数、肛门排气时间及术后住院时间与TVH组比较差异无统计学意义(P>0.05)。结论:LAVH及TVH临床疗效优于TAH,并且LAVH降低了TVH手术难度,扩大了TVH手术范围,较TVH优势明显。
Objective: To investigate the clinical effect of open, vaginal and laparoscopic assisted vaginal hysterectomy. Methods: A retrospective analysis of 300 cases of total hysterectomy patients, including laparoscopic assisted vaginal hysterectomy (LAVH) in 101 cases, vaginal hysterectomy (TVH) in 106 cases, open hysterectomy ( TAH) in 93 cases. The operation time, blood loss, postoperative morbidity, anal exhaust time, analgesia and postoperative hospital stay were compared between the three groups. Results: There was no significant difference in the operation time between TAH, TVH and LAVH groups (P> 0.05). The blood loss, postoperative morbidity and analgesia in LAVH and TVH groups were significantly better than those in TAH group (P <0.05), and the incidence of postoperative LAVH group was significantly better than TVH group (P <0.05). The anal exhaust time and postoperative hospital stay in LAVH and TVH groups were significantly shorter than those in TAH group, with statistical significance (P <0.05). There was no significant difference in the amount of bleeding, analgesia, anal exhaust time and postoperative hospital stay between LAVH group and TVH group (P> 0.05). Conclusion: The clinical effects of LAVH and TVH are better than that of TAH, and LAVH reduces the difficulty of TVH operation and enlarges the scope of TVH surgery, which has obvious advantages over TVH.