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目的 :通过对 4 2例腹腔镜筋膜内子宫切除术 (CISH)的术式分析 ,进一步探讨改良后的腹腔镜筋膜内子宫切除术的手术要点及临床应用价值。方法 :自 1998年 2月以来 ,4 2例因各种良性妇科疾病而需行子宫全切术的患者中 10例采用标准SEMM式腹腔镜全宫切除术 ,3 2例采用改良CISH术式。患者平均年龄 4 5岁 ( 3 6～ 5 4岁 ) ,术前子宫增大如孕 6周大小 5例 ,孕 8～ 10周大小 3 0例 ,孕 11～ 12周大小 7例。结果 :改良后的CISH平均手术时间 95min( 60～ 13 5min) ,平均出血量 ( 5 0± 14 .5 4 )ml( 2 0～ 10 0ml) ,平均住院日 4 .2d。结论 :改良的CISH较标准的CISH术操作更简捷、术程短、出血少。
Objective: To further investigate the operative points and clinical value of modified laparoscopic intrafascial hysterectomy by analyzing 42 cases of laparoscopic intrafascial hysterectomy (CISH). Methods: Since February 1998, 42 patients undergoing total hysterectomy due to various benign gynecological diseases were treated with standard SEMM laparoscopic total hysterectomy and 32 with modified CISH. The average age of patients was 45 years (36 ~ 54 years). Preoperative uterine enlargement was 5 weeks pregnant 6 weeks, 30 cases pregnant 8 ~ 10 weeks and 7 cases 11 ~ 12 weeks pregnant. Results: The average operative time of modified CISH was 95min (60-13 5min), average bleeding amount was (50 ± 14.54) ml (20 ~ 100ml), average hospital stay was 4. 2d. Conclusion: The modified CISH is more simple, shorter procedure and less bleeding than the standard CISH operation.