腹腔镜全子宫切除术与经腹全子宫切除术及阴式全宫切除术比较分析

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目的:观察阴式全宫切除术、经腹全子宫切除术和腹腔镜全子宫切除术的临床疗效,分析其优缺点。方法:选取2013年4月~2015年8月之间于我院妇科行全子宫切除术的150例患者,按照手术方式分为阴式手术组(50例,行阴式全子宫切除术)、经腹手术组(50例,行经腹全子宫切除术)和腹腔镜组(50例,行腹腔镜下全子宫切除术),比较三组的手术情况和预后效果。结果:腹腔镜组和阴式手术组的术中出血量少于经腹手术组,手术时间长于经腹手术组,其术后镇痛率分别为64.0%和68.0%,低于经腹手术组(92.0%),并发症发生率均为0,低于经腹手术组(8.0%),住院时间和肛门排气时间短于经腹手术组,差异显著,P<0.05。结论:在治疗子宫良性病变方面,经腹全子宫切除术虽然手术时间短,但出血量多,术后疼痛强烈,大多需采用镇痛,且恢复时间长。临床上最好采用阴式全子宫切除术和腹腔镜下全子宫切除术,但具体应根据患者的实际情况选择。 Objective: To observe the clinical effect of vaginal hysterectomy, abdominal total hysterectomy and laparoscopic hysterectomy, analyze its advantages and disadvantages. Methods: A total of 150 patients underwent gynecological hysterectomy in our hospital between April 2013 and August 2015 were divided into three groups according to the operation: vaginal surgery group (50 cases, vaginal hysterectomy) Transabdominal surgery group (50 cases, transabdominal total hysterectomy) and laparoscopic group (50 cases underwent laparoscopic hysterectomy), the operation and prognosis of the three groups were compared. Results: The intraoperative blood loss of laparoscopic group and vaginal group was less than that of transabdominal group, and the operation time was longer than that of transabdominal group. The postoperative analgesia rates were 64.0% and 68.0% respectively, lower than that of transabdominal group (92.0%). The complication rates were all 0, lower than those in the transabdominal group (8.0%). The length of hospital stay and anal exhaust were shorter than those in the transabdominal group (P <0.05). Conclusion: In the treatment of benign uterine lesions, transabdominal hysterectomy although the operation time is short, but the amount of bleeding, postoperative pain, most of the need for analgesia, and long recovery time. The best clinical use of vaginal hysterectomy and laparoscopic hysterectomy, but the specific should be based on the actual situation of patients to choose.
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