腹腔镜次全子宫切除术的临床应用(1)
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[摘要] 目的:探讨腹腔镜下子宫次全切除术(laparoscopic supracervical hysterectomy,LSH)的临床特点及临床应用价值。方法:回顾分析本院2009年1～12月39例LSH与2008年1～12月31例开腹子宫次全切除术(abdominal supracervical hysterectomy,ASH)患者的临床资料,比较2种手术方式术中出血量、手术时间、肠功能恢复、术后下床时间及术后住院时间等情况。结果:两组术中出血量比较,差异无统计学意义;LSH组手术时间明显长于ASH组;LSH组术后肛门排气时间明显早于ASH组;LSH组术后下床时间明显早于ASH组;LSH组术后住院时间短于ASH组。两组无手术并发症发生。结论:LSH较ASH的优势明显,如果腹腔镜下操作技巧熟练,腹腔镜子宫次全切除术是一种理想的手术方式。
[关键词] 腹腔镜;子宫次全切除术
[中图分类号] R713.4+2 [文献标识码]A [文章编号]1674-4721(2010)04(c)-024-02
The clinical application of laparoscopic supracervical hysterectomy
WANG Zhenwen,TANG Wei
(Obstetrics and Gynecology,Qiaotou Hospital of Dongguan,Dongguan 523000, China)
[Abstract] Objective: To explore the clinical value of laparoscopic supracervical hysterectomy(LSH). Methods: From January to December 2009,39 cases of LSH and 31 cases of abdominal supracervical hysterectomy(ASH) in January to December 2008 were issued in our hospital.The clinical data of the patients which included intraoperative blood loss, operation time, recovery time of bowel function, postoperative time of out-of-bed activity and postoperative hospital stay were analyzed and compared between the two groups. Results: No significant difference was found on the mean intraoperative blood loss between the LSH group and ASH group.The LSH group had significantly longer operation time and faster recovery of the gastrointestinal function than the ASH group.Furthermore,the LSH patients had out-of-bed activity and were discharged from hospital significantly earlier than the ASH group.No major complication occurred in either of the two groups. Conclusion: LSH shows great advantages over ASH.As long as surgeons are done with required skills in laparoscopic operation, LSH can be an ideal procedure for hysterectomy.
[Key words] Laparoscopy; Laparoscopic supracervical hysterectomytopic
子宫次全切除术的传统方式是经腹手术。近年来,腹腔镜器械的进步和镜下操作技术水平的不断提高,改变了传统妇产科疾病的诊断和治疗模式。腹腔镜下次全子宫切除术是在腹腔镜下切除子宫体而保留子宫颈的手术。该术式在切除已发生病变的子宫体和子宫内膜的同时,保留了正常的子宫颈和盆底支持结缔组织,是一种适合于因子宫病变需要切除子宫体而又相对较年轻的女性患者的手术方式。本院2009年1～12月行腹腔镜子宫次全切除术39例,于2008年1～12月经腹子宫次全切除术31例。在出血、手术时间、术后恢复等方面进行比较,进一步探讨腹腔镜下子宫次全切除术(LSH)的临床应用价值 ......
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