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目的比较、探讨三种子宫切除术的临床价值。方法按术式不同将351例患者分成腹腔镜辅助经阴道子宫切除术(laparoscopic-assisted vaginal hysterectomy,LAVH)组、经阴道全子宫切除术(totalvaginal hysterectomy,TVH)组和腹式子宫切除术(total abdominal hysterectomy,TAH)组,比较手术时间,术中出血量和术后情况。结果三种术式术后均无并发症发生。LAVH组手术时间长于TAH组和TVH组(P<0.05),TVH组和TAH组无明显差异(P>0.05);LAVH组和TAH组比TVH组出血多,差异有显著性(P<0.05)。术后发病率、术后排气时间、下床活动时间、镇痛剂使用率、住院时间等,TAH组与TVH组及LAVH组比较差异有统计学意义(P<0.05)。结论三种术式各有利弊,医生在手术前应综合评估病情,根据不同个体选择不同方案以达到最佳效果。
Objective To compare the clinical value of three kinds of hysterectomy. Methods 351 patients were divided into laparoscopic-assisted vaginal hysterectomy (LAVH) group, total vaginal hysterectomy (TVH) group and abdominal hysterectomy (total abdominal hysterectomy, TAH) group. The operation time, intraoperative blood loss and postoperative condition were compared. Results There were no postoperative complications in any of the three surgical procedures. LAVH group had longer operation time than TAH group and TVH group (P <0.05), TVH group and TAH group had no significant difference (P> 0.05); LAVH group and TAH group had more bleeding than TVH group (P <0.05) . Postoperative morbidity, postoperative exhaust time, ambulation time, analgesic usage, hospital stay, etc. There was significant difference between TAH group and TVH group and LAVH group (P <0.05). Conclusion There are pros and cons of the three kinds of surgical procedures. Doctors should evaluate the condition comprehensively before surgery, and choose the best one according to different individual.