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目的:比较腹式子宫切除术(TAH)、阴式子宫切除术(TVH)与腹腔镜辅助下阴式子宫切除术(LAVH)的不同手术适应证及效果,探讨3种子宫切除术式的最佳选择。方法:回顾性分析安徽省立友谊医院2005年9月～2007年12月及也门哈德拉毛大学附属木卡拉医院2008年1月～12月接受上述3种不同术式子宫切除术病例62例,比较3种手术在手术时间、术中出血量、术后肛门排气时间、术后下床活动时间、术后住院日、术中术后并发症及3者的手术适应证(尤其是子宫大小、盆腔粘连等)。结果:3组平均手术时间、术中平均出血量无统计学差异(P>0.05);TVH组及LAVH组在术后肛门排气时间、术后下床活动时间、术后住院天数、术后疼痛及体温方面与TAH组比较差异有统计学意义(P<0.05)。结论:TVH与LAVH为创伤小、恢复快的微创手术,但TVH适应于子宫小、无粘连并伴下垂者,而LAVH扩大了TVH的适应证,拓宽了阴式手术的选择范围。
OBJECTIVE: To compare different indications and effects of abdominal hysterectomy (TAH), vaginal hysterectomy (TVH) and laparoscopic assisted vaginal hysterectomy (LAVH), and to investigate the effect of three kinds of hysterectomy Good choice. Methods: A retrospective analysis of Anhui Provincial Friendship Hospital from September 2005 to December 2007 and Yemen Alhambra University Mukhala Hospital from January 2008 to December 2008 received the above three different cases of hysterectomy cases 62 cases, The operation time, intraoperative blood loss, postoperative anal exhaust time, postoperative ambulation time, postoperative hospital stay, intraoperative and postoperative complications and surgical indications of 3 patients (especially uterine size , Pelvic adhesions, etc.). Results: There was no significant difference in average operative time and average blood loss between the three groups (P> 0.05). The time of postoperative anus exhaust, postoperative ambulation, postoperative hospital stay, TVH group and LAVH group after operation Pain and body temperature with TAH group, the difference was statistically significant (P <0.05). CONCLUSION: TVH and LAVH are minimally invasive surgery with minimal trauma and fast recovery. However, TVH is suitable for small uterine adhesions without prolapse, and LAVH expands the indication of TVH and broadens the range of options for vaginal surgery.