切换至 "中华医学电子期刊资源库"

中华妇幼临床医学杂志(电子版) ›› 2011, Vol. 07 ›› Issue (05) : 461 -463. doi: 10.3877/cma.j.issn.1673-5250.2011.05.014

论著

阴式子宫切除术与腹腔镜辅助阴式子宫切除术的术式比较
鲁春雁   
  1. 471002 河南洛阳,洛阳市第三人民医院妇产科
  • 出版日期:2011-10-01

Comparison of Clinical Effects Between Vaginal Hysterectomy and Laparoscopically Assisted Vaginal Hysterectomy

Chun-yan LU   

  1. Luoyang No. 3 People's Hospital, Luoyang 471002, Henan Province, China
  • Published:2011-10-01
引用本文:

鲁春雁. 阴式子宫切除术与腹腔镜辅助阴式子宫切除术的术式比较[J]. 中华妇幼临床医学杂志(电子版), 2011, 07(05): 461-463.

Chun-yan LU. Comparison of Clinical Effects Between Vaginal Hysterectomy and Laparoscopically Assisted Vaginal Hysterectomy[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2011, 07(05): 461-463.

目的

探讨阴式子宫切除术(TVH)和腹腔镜辅助阴式子宫切除术(LAVH)的临床效果及应用价值。

方法

回顾性分析2007年1月至2010年12月在本院行TVH的86例患者(TVH组)与同期行LAVH的92例患者(LAVH组)的临床资料,对两组患者术中、术后情况进行统计学分析(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,并与其签署临床研究知情同意书)。两组患者既往盆腔手术史、孕次、产次、合并贫血及子宫增大(相应孕周)情况比较,差异无统计学意义(P> 0.05)。

结果

TVH组患者手术时间、术中出血量及手术费用均较LAVH组短、少和低,两组比较,差异有统计学意义(P<0.05);但术后排气时间、术后病率及住院时间比较,差异无统计学意义(P>0.05)。所有患者无一例中转开腹及脏器损伤或大出血等严重并发症发生,均无发热、肠粘连、肠梗阻和术后血栓性静脉炎等手术相关并发症。

结论

TVH较LAVH具有手术时间短、术中出血量少、费用低廉等优势,但TVH更适应于子宫大小<孕4个月、盆腔无明显粘连患者。LAVH可扩大TVH的适应证。临床应根据个体情况选择合适的子宫切除方式,以达到最佳治疗效果。

Objective

To evaluate clinical effects between vaginal hysterectomy (TVH) and laparoscopic assisted vaginal hysterectomy (LAVH).

Methods

From January to December 2010, a total of 86 patients with TVH (TVH group) and 92 patients with LAVH (LAVH group) were recruited into this study. Their clinical data before and after the operation were statistically analyzed. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Luoyang No. 3 People's Hospital. Informed consent was obtained from all participants. There were no statistical difference on pelvic operation history, gravidity, parity, anemia during pregnancy, and hysterauxesis (P>0.05).

Results

The operation time, blood loss volume and operation cost of TVH group was shorter, less, and lower than those of LAVH group (P < 0.05). There were no statistically significant difference on time of farting, postoperative morbidity and hospitalization time between two group (P>0.05). None of serious complication was occurred.

Conclusion

Compared with LAVH, TVH has the advantage of shorter operative time, less blood loss and lower cost, but it is more adapted to whom the uterus is in 4-month pregnancy and without pelvic adhesions. LAVH expanded TVH's adaptation. We should choose appropriate way according to different clinical conditions for the best therapeutic effects.

1 Liu Y. Review and outlook of hysterectomy [J]. Chin J Gynecol Obstet, 2009, 25 (1): 8-9.[刘彦.子宫切除术回顾与展望[J].中国实用妇科与产科杂志,2009,25 (1): 8-9.]
2 Amy JJ. Vaginal hysterectomy [J]. Natl Med J Ind, 1997, 10(2):126-127.
3 Kobac S. Guideline to determine the route of hysterectomy [J]. Obstet Gynecol, 1995, 176(1): 18-22.
4 Ricardo M, Mauro B, Errico Z, et al. Laparoscopically assisted vaginal hysterectomy versus total abdominal hysterectomy: A prospective? randomized, multicenter study [ J]. Am J Obstet Gynecol, 1999, 180(2): 270-275.
5 Li GY, ed. Practical laparoscopic surgery [M]. Beijing: People's Medial Publishing House, 2006, 272-300.[李光仪,主编.实用妇科腹腔镜手术学[M].北京:人民卫生出版社,2006,272-300.]
6 Kovac SR. Transvaginal hysterectomy rationale and surgical approach [J]. Obstet Gynecol, 2004, 103(6): 1321-1325.
[1] 陈敏华, 朱峥, 金君, 孙仁华, 陈健良. B型利钠肽在预测重症患者急性肾损伤发生发展中的临床价值[J]. 中华危重症医学杂志(电子版), 2022, 15(04): 279-284.
[2] 牛秀敏, 臧春逸. 不同术式治疗重度盆腔脏器脱垂的临床疗效分析[J]. 中华妇幼临床医学杂志(电子版), 2013, 09(01): 75-80.
[3] 张玉凤, 万涵, 樊华峰, 袁娟, 刘瑞清, 徐鹏飞, 王军, 邓慧玲. 高迁移率族蛋白1在肠道病毒71型手足口病患者中的表达及临床价值[J]. 中华实验和临床感染病杂志(电子版), 2022, 16(01): 9-15.
[4] 周泱, 孙丽琴, 吕德良, 程林, 李莎茜, 徐六妹, 王辉. 血清乳酸脱氢酶检测在获得性免疫缺陷综合征患者合并机会感染中的临床价值[J]. 中华实验和临床感染病杂志(电子版), 2018, 12(04): 341-347.
[5] 汤程旭, 陈文龙, 杨蕊. MRI联合钼靶X线在乳腺导管原位癌的诊断价值[J]. 中华普外科手术学杂志(电子版), 2020, 14(05): 480-482.
[6] 朱朝霞, 蒋莉莉, 张安乐, 邬小龙. 阴式子宫切除术联合阴道前后壁修补术对子宫脱垂合并阴道壁膨出患者术后疼痛及复发的影响[J]. 中华疝和腹壁外科杂志(电子版), 2020, 14(05): 532-535.
[7] 曹为英, 赵树娟. 子宫脱垂患者行阴式子宫切除术联合阴道前后壁修补术后合并新发性压力性尿失禁的影响因素[J]. 中华疝和腹壁外科杂志(电子版), 2020, 14(01): 63-66.
[8] 王道猛, 钱斌, 孟阳春, 何小勇. 基于oncomine数据荟萃分析探讨FOXM1在非小细胞肺癌中的表达与临床预后关系[J]. 中华肺部疾病杂志(电子版), 2020, 13(05): 666-668.
[9] 常蕊, 刘阳, 冯彩霞, 刘尚华, 王楠, 高燕云. 改良腹腔镜辅助阴式切除巨大子宫临床疗效探究[J]. 中华腔镜外科杂志(电子版), 2016, 09(03): 168-171.
[10] 李衡, 吴清华, 刘昌贺, 袁艺文, 吕正颀. 可移动125I粒子条联合经皮肝胆管内外引流术治疗肝门部胆管癌的临床价值[J]. 中华介入放射学电子杂志, 2023, 11(01): 48-54.
[11] 李冬玲, 刘寿芳, 尹光凤, 李晓非, 李松鹏. 血清ProGRP、CEA、CYFRA211、NSE、CA199和AFP联合检测在肺癌诊断的临床价值[J]. 中华临床实验室管理电子杂志, 2019, 07(03): 145-149.
[12] 钱亿超. 优质护理对急性心肌梗死患者的临床价值[J]. 中华卫生应急电子杂志, 2017, 03(05): 312-314.
阅读次数
全文


摘要