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目的探讨经腹全子宫切除术(TAH)和经腹腔镜全子宫切除术(TLH)的临床应用情况及临床效果。方法回顾性分析200例同期行全子宫切除手术患者的临床资料,对经腹全子宫切除术(经腹组)、经腹腔镜全子宫切除手术(腹腔镜组)患者术中、术后情况进行比较。结果腹腔镜组手术时间为(103±23)min,经腹组为(75±30)min,两组差异有统计学意义(P<0.01)。腹腔镜组术中出血量为(105±48)ml,经腹组为(100±28)ml,两组差异无统计学意义(P>0.05)。腹腔镜组的术后肛门排气时间[(20.00±3.42)h]明显短于经腹组[(38.40±5.30)h],差异有统计学意义(P<0.01)。腹腔镜组的术后抗生素应用时间[(4±1)d]短于经腹组[(6±1)d],差异有统计学意义(P<0.01)。腹腔镜组的术后住院日为[(5.45±1.22)d],明显短于经腹组[(7.03±1.56)d],差异有统计学意义(P<0.01)。结论两种途径的手术各有优缺点,且不能相互代替,临床医生应根据患者病情和术者的技术水平来选择不同的手术方式。
Objective To investigate the clinical application and clinical results of transabdominal total hysterectomy (TAH) and laparoscopic total hysterectomy (TLH). Methods The clinical data of 200 patients undergoing hysterectomy during the same period were retrospectively analyzed. The patients underwent transabdominal hysterectomy (transabdominal group) and laparoscopic hysterectomy (laparoscopic group) underwent surgery and postoperatively Compare Results The laparoscopic operation time was (103 ± 23) min and (75 ± 30) min in the abdomen group, the difference was statistically significant (P <0.01). The amount of bleeding in laparoscopic group was (105 ± 48) ml and (100 ± 28) ml in abdomen group, respectively. There was no significant difference between the two groups (P> 0.05). The time of postoperative anal exhaust in laparoscopic group [(20.00 ± 3.42) h] was significantly shorter than that in transabdominal group [(38.40 ± 5.30) h], the difference was statistically significant (P <0.01). The duration of postoperative antibiotic use in laparoscopic group was shorter than that in abdominal group [(4 ± 1) d] [(6 ± 1) d] (P <0.01). The length of postoperative hospital stay was (5.45 ± 1.22) days in laparoscopic group, which was significantly shorter than that in abdominal group (7.03 ± 1.56 days) (P <0.01). Conclusion There are advantages and disadvantages of the two methods of operation, and can not replace each other, clinicians should be based on the patient’s condition and the skill level of the surgeon to choose a different surgical approach.