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目的探讨腹腔镜辅助阴式子宫切除术(LAVH)的临床价值。方法对自2005年10月至2008年10月行LAVH126例患者的资料(腹腔镜组)进行回顾性分析,选同期基本情况相当的126例经腹子宫切除术(TAH)患者作为对照组(开腹组),比较两组手术时间、术中出血量、手术并发症及术后恢复情况。结果①手术时间:腹腔镜组90～175 min,平均125 min,开腹组48～115 min,平均75 min,差异有统计学意义(P<0.05)。②术中出血量:腹腔镜组出血量50～90 m1,平均75.5 ml,开腹组出血量110～160 ml,平均128.5 ml,差异有统计学意义(P<0.05)。③术后恢复情况:腹腔镜组术后3 d内平均最高体温、平均肛门排气时间、平均开始下床活动时间分别为37.5℃、20 h、9.5 h;开腹组术后3 d内平均最高体温、平均肛门排气时间、平均下床活动时间分别为38.6℃、48 h、40 h;以上各指标两组比较,差异均有统计学意义(P<0.05)。④手术并发症发生率:腹腔镜组为3.17%,开腹组为2.38%,差异无统计学意义(P>0.05)。结论LAVH可拓宽阴式子宫切除术的适用范围,具有术中出血少、术后恢复快等优点,是一种安全、有效的术式。
Objective To investigate the clinical value of laparoscopic assisted vaginal hysterectomy (LAVH). Methods A retrospective analysis was performed on the data of 126 cases of LAVH patients (laparoscopic group) from October 2005 to October 2008. A total of 126 cases of TAH patients with similar basic conditions at the same period were selected as the control group Abdominal group). The operation time, intraoperative blood loss, surgical complications and postoperative recovery were compared between the two groups. Results ①Operation time: Laparoscopic group 90 ~ 175 min, average 125 min, open group 48 ~ 115 min, average 75 min, the difference was statistically significant (P <0.05). ② blood loss in laparoscopic group: 50 ~ 90 m1 in the laparoscopic group, with an average of 75.5 ml, the amount of bleeding in the open group was 110 ~ 160 ml, an average of 128.5 ml, the difference was statistically significant (P <0.05). ③Postoperative recovery: The mean maximum body temperature and mean time to anus exhaust within 3 days after laparoscopic surgery were 37.5 ℃, 20 h and 9.5 h, respectively. The mean The maximum body temperature, the average anal exhaust time, and the average ambulation time were 38.6 ℃, 48 h, 40 h respectively. There was significant difference between the above two groups (P <0.05). ④ The incidence of complications: laparoscopic group was 3.17%, laparotomy group was 2.38%, the difference was not statistically significant (P> 0.05). Conclusion LAVH can broaden the scope of application of vaginal hysterectomy, with less bleeding, rapid recovery and so on, is a safe and effective surgical procedures.