论文部分内容阅读
目的 :探讨腹腔镜下子宫全切除术的改良,是否可以有效避免术中输尿管损伤,减少术中出血量,缩短手术时间。方法:分析本院2011年6月~2013年5月间,453例腹腔镜下子宫全切除术患者的临床资料,其中采用常规的腹腔镜下子宫全切除术220例,采用改良的腹腔镜下子宫全切除术233例,比较两组患者的手术时间、术中出血量、术后住院时间、术中术后并发症、肠道恢复时间。结果:研究组和对照组手术时间分别为(71.33±11.09)min和(122.36±15.49)min,术中出血量分别是(31.94±10.26)ml和(173.41±14.40)ml,术后肛门排气时间分别是(30.52±2.09)h和(50.97±6.05)h,两组比较差异均有统计学意义(P<0.05)。研究组术中术后并发症发生2例(皮下气肿1例、术后病率1例),对照组术中术后并发症发生8例(术中输尿管损伤4例、术中血管损伤1例、皮下气肿1例、术后病率2例),两组比较差异有统计学意义(P<0.05)。结论:改良的腹腔镜下子宫全切术在手术时间、术中出血量、术中术后并发症、术后肠道恢复方面明显优于常规腹腔镜下子宫全切除术,是有效可行的。
Objective: To explore the improvement of laparoscopic total hysterectomy, whether it can effectively avoid intraoperative ureteral injury, reduce intraoperative bleeding, shorten the operation time. Methods: From June 2011 to May 2013 in our hospital, 453 patients underwent laparoscopic hysterectomy were analyzed retrospectively. Among them, 220 patients underwent laparoscopic total hysterectomy using modified laparoscopic Total hysterectomy in 233 cases, the two groups of patients were compared operation time, blood loss, postoperative hospital stay, postoperative complications, intestinal recovery time. Results: The operation time of the study group and the control group were (71.33 ± 11.09) min and (122.36 ± 15.49) min respectively, and the intraoperative blood loss was (31.94 ± 10.26) ml and (173.41 ± 14.40) ml, respectively. The time was (30.52 ± 2.09) h and (50.97 ± 6.05) h, respectively, with significant difference between the two groups (P <0.05). There were 2 cases of postoperative complications (1 case of subcutaneous emphysema and 1 case of postoperative morbidity) in the study group. There were 8 cases of intraoperative and postoperative complications in the study group (4 cases of intraoperative ureteral injury, 1 case of vascular injury 1 Cases, subcutaneous emphysema in 1 case, postoperative morbidity in 2 cases), the difference between the two groups was statistically significant (P <0.05). Conclusion: The modified laparoscopic total hysterectomy is more effective than conventional laparoscopic total hysterectomy in operation time, intraoperative blood loss, intraoperative and postoperative complications, and postoperative intestinal recovery.