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目的探讨腹腔镜辅助下阴式子宫切除术在基层医院的应用前景。方法将68例患者分成腹腔镜辅助下阴式子宫切除术组(LAVH)和传统经腹全子宫切除术组(TAH)两组。比较其手术时间、出血量、血红蛋白下降、术后疼痛、术后病率、肛门恢复排气时间、住院时间及费用等情况。结果两组患者均手术顺利,未发生并发症,LAVH组亦无中转开腹。在术后疼痛、肛门恢复排气时间、住院时间LAVH组明显优于TAH组(P<0.01),在血红蛋白下降及术后病率两组差异无统计学意义(P>0.05),在手术时间及经济方面TAH组优于LAVH组(P<0.01)。结论腹腔镜辅助下阴式子宫切除术虽然手术时间较长,费用相对昂贵,但因其创伤小、恢复快且较腹腔镜下子宫切除术(LTH)易于操作,故在基层医院应用前景广泛。
Objective To explore the application of laparoscopic assisted vaginal hysterectomy in primary hospital. Methods 68 patients were divided into laparoscopic assisted vaginal hysterectomy group (LAVH) and traditional abdominal hysterectomy group (TAH) two groups. Compare the operation time, blood loss, hemoglobin decline, postoperative pain, postoperative morbidity, anus recovery exhaust time, hospitalization time and cost and so on. Results The two groups of patients were operated smoothly, no complications occurred, and no laparotomy was performed in LAVH group. The postoperative analgesia, anus recovery exhaust time and hospital stay in the LAVH group were significantly better than those in the TAH group (P <0.01). There was no significant difference between the two groups in hemoglobin decline and postoperative morbidity (P> 0.05) In economic terms, TAH group was better than LAVH group (P <0.01). Conclusions Laparoscopy-assisted vaginal hysterectomy, although relatively long and costly, can be widely used in primary hospitals because of its low trauma, rapid recovery and ease of operation compared with laparoscopic hysterectomy (LTH).