306例腹腔镜检查下阴式子宫全切术临床分析

• 作 者: 林湖滨 郝敏
• 机 构: 山西医科大学,山西医科大学第二医院妇产科,
• 出 处: 中国医疗前沿
• 发表日期: 2009年23期
• 关键词: 阴式子宫切除术(TVH) 腹腔镜检查

目的探讨腹腔镜检查在阴式子宫全切术(TVH)中的优点及应用价值。方法回顾性分析山西医科大学第二医院2005年4月～2009年2月间行腹腔镜检查下TVH手术的306例的临床资料,分析手术时间、出血量、术后住院日、术中术后并发症和术中临时处理等临床效果以及手术适应症,尤其是子宫大小、盆腔粘连和附件情况。结果腹腔镜检查阴式子宫全切术术中发现子宫大于3月患者占28.1%,腹腔粘连患者占29.4%;腹腔镜下对全部粘连患者进行粘连松解,分别为37.2%和4.2%患者进行附件手术和子宫内膜异位灶电灼术,术中2例腹腔镜检查后评估不适行阴式手术改开腹手术;所有临床效果好,患者均痊愈出院。结论腹腔镜检查扩大了TVH的适应症及提高了其安全性,对TVH的广泛开展起到了很大的促进作用。

Objective To explore the advantages and the value of laparoscopy in vaginal hysterectomy (TVH). Methods The clinical data of 306 patients who underwent laparoscopy for TVH during the period from April 2005 to February 2009 in the Second Hospital of Shanxi Medical University were retrospectively analyzed. The operative time, amount of bleeding, postoperative hospital stay, intraoperative and postoperative Complications and intraoperative temporary treatment and other clinical effects and surgical indications, especially the size of the uterus, pelvic adhesions and attachment conditions. Results Laparoscopy vaginal hysterectomy surgery found that the uterus was more than 3 months in patients with 28.1%, patients with abdominal adhesions accounted for 29.4%; laparoscopic adhesion adhesions in all patients with adhesions were 37.2% and 4.2% of patients Annex surgery and endometriosis lesions electrocautery, intraoperative 2 laparoscopic assessment of discomfort vaginal surgery to open laparotomy; all clinical effects, patients were discharged. Conclusion Laparoscopy has expanded the indications of TVH and improved its safety, and has played a significant role in promoting the widespread development of TVH.