论文部分内容阅读
目的探讨腹腔镜下使用不同能量发生器切除子宫对阴道残端愈合的影响。方法 2007-10-2009-10阳市妇女儿童医疗保健中心腹腔镜下子宫全切及腹腔镜辅助阴式子宫切除的患者239例,所有阴道残端均经阴道用强生1-0薇荞可吸收线缝合。共分三组:用双极电凝切割阴道穹窿顶者为电凝组,78例;超声刀切割阴道穹窿顶者为超声刀组,80例;冷刀切割阴道穹窿顶者为冷刀组,81例。比较三组患者术后阴道残端肉芽组织发生、阴道流血、阴道流液、包括阴道流脓等发生率。结果发生阴道残端肉芽组织在电凝组为8/78,超声刀组为4/80,对照组为4/81;发生阴道流血电凝组为7/78,超声刀组为2/80,对照组为3/81;阴道流液(包括阴道流脓)电凝组为11/78,超声刀组为4/80,对照组为4/81。电凝组发生肉芽组织发生率、阴道流血及阴道流液均高于对照组(P<0.05),超声刀组肉芽组织发生率、阴道流血及阴道流液与对照组无明显差异(P>0.05)。结论在腹腔镜子宫切除术中处理阴道残端,超声刀是一种较好的能量发生器。
Objective To investigate the effect of laparoscopic resection of the uterus with different energy generators on the healing of vaginal stumps. Methods 2007-10-2009-10 Yang City, Women and Children’s Medical Center Laparoscopic hysterectomy and laparoscopic assisted vaginal hysterectomy in 239 patients, all vaginal stump vaginal use of Johnson 1-0 buckwheat can absorb Suture. Divided into three groups: bipolar coagulation with vaginal vault top for the coagulation group, 78 cases; ultrasonic knife to cut the vaginal vault top for the ultrasound knife group, 80 cases; cold knife to cut the top of the vagina for the cold knife group, 81 cases. The incidence of vaginal stump granulation tissue, vaginal bleeding, vaginal fluid and vaginal pus were compared between the three groups. Results The incidence of vaginal stump granulation tissue was 8/78 in the coagulation group, 4/80 in the ultrasound knife group and 4/81 in the control group, 7/78 in the vaginal bleeding coagulation group, 2/80 in the ultrasound knife group, The control group was 3/81; the vaginal fluid (including vaginal pus) was 11/78 in the electrocoagulation group, 4/80 in the ultrasound knife group, and 4/81 in the control group. The incidence of granulation tissue, vaginal bleeding and vaginal fluid in the coagulation group were higher than those in the control group (P <0.05). The incidence of granulation tissue, vaginal bleeding and vaginal fluid in the ultrasound group were not significantly different from those in the control group (P> 0.05 ). Conclusion Laparoscopic hysterectomy in the treatment of vaginal stump, ultrasonic knife is a good energy generator.