两种术式治疗非脱垂良性子宫病变的效果比较

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目的比较腹腔镜辅助阴式全子宫切除术(LAVH)和经阴式全子宫切除术(TVH)治疗非脱垂良性子宫病变的临床疗效。方法选取非脱垂良性子宫病变患者共70例,随机分为实验组和对照组。实验组予以LAVH手术,对照组予以TVH手术。对比两组患者手术一般情况、手术前后血红蛋白水平、切口甲级愈合率、术后性功能和术后并发症发生率。结果实验组手术时间与对照组比较显著延长(P<0.01),实验组术中出血量、术后下床活动时间、术后排气时间以及住院时间与对照组比较,均显著缩短(P<0.01);两组术后3个月血清血红蛋白含量与术前比较均显著上升(P<0.05),且实验组较对照组上升幅度更明显(P<0.01);两组患者切口甲级愈合率无统计学差异(P>0.05);实验组术后性交障碍和性交痛较对照组显著改善,性高潮次数显著高于对照组(P<0.05);实验组术后并发症发生率显著低于对照组(P<0.05)。结论 LVAH治疗非脱垂良性子宫病变创伤较小,术后恢复快,患者性功能改善明显,并发症发生率较低,优于TVH。 Objective To compare the clinical efficacy of laparoscopic assisted vaginal hysterectomy (LAVH) and vaginal hysterectomy (TVH) in the treatment of non-prolapsed benign uterine lesions. Methods A total of 70 patients with non-prolapsed benign uterine lesions were selected and randomly divided into experimental group and control group. The experimental group was treated with LAVH and the control group with TVH. The general operation, the hemoglobin level before and after surgery, the grade C incision healing, the postoperative sexual function and the postoperative complication rate were compared between the two groups. Results The operation time of the experimental group was significantly longer than that of the control group (P <0.01). The bleeding volume, ambulation time, postoperative exhaust time and hospital stay in the experimental group were significantly shorter than those in the control group (P < 0.01). The levels of hemoglobin in the two groups were significantly increased at 3 months after operation compared with that before operation (P <0.05), and the increase rate of the experimental group was more obvious than that of the control group (P <0.01) No significant difference (P> 0.05). The experimental group had significantly improved postoperative sexual dysfunction and painful intercourse compared with the control group, and the number of orgasm was significantly higher than that of the control group (P <0.05). The incidence of postoperative complications in the experimental group was significantly lower than that of the control group Control group (P <0.05). Conclusion LVAH has less trauma and benign recovery in non-prolapsed benign uterine lesions. The improvement of sexual function and the complication rate of LVAH are better than TVH.
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