腹腔镜子宫切除术的临床效果及应用价值研究

目的:探讨腹腔镜子宫切除术的临床效果和应用价值。方法:将720例因子宫病变有子宫切除指征患者随机分成腹腔镜组和开腹组,并按照腹腔镜手术指征选择4种不同的手术方式,对比腹腔镜子宫次全切除术、腹腔镜筋膜内子宫切除术、腹腔镜辅助阴式子宫切除术、全腹腔镜子宫切除术和开腹组间手术成功率、并发症发生率、术中及恢复情况和全身炎症反应综合症方面的差异。结果:腹腔镜四组手术成功率都在95%以上,远大于开腹组手术成功率(87.4%)(P<0.05)。腹腔镜四组并发症发生率远小于开腹组(P<0.05)。腹腔镜四组在手术成功率和并发症发生率方面差异无统计学意义(P>0.05)。腹腔镜四组在手术时间、术中出血量、住院天数及住院费用方面均低于开腹组(P<0.05)。而腹腔镜四组间比较差异均无统计学意义(P>0.05)。腹腔镜四组全身炎症反应综合症发生率和持续时间均低于开腹组(P<0.05),而腹腔镜四组间比较差异则无统计学意义(P>0.05)。结论:腹腔镜子宫切除术临床效果较好,安全有效,创伤小,费用低,适合符合手术指证的患者应用。

The Clinical Effectiveness and Value of Laparoscopic Hysterectomy

Objective: To investigate the clinical effectiveness and value of laparoscopic hysterectomy.Methods:720 cases of uterine disease with hysterectomy indications were divided into laparoscopic group and laparotomy group,and four kinds of different methods were used according to indications in laparoscopic surgery.Compare the surgical success rate,complication rate,intraoperative and recovery situations and differences in the systemic inflammatory response syndrome between the groups of Laparoscopic Supracervical hysterectomy(LSH),Classical Intrafascial Supracervical Hysterectomy(CISH),Laparoscopic assisted vaginal hysterectomy(LAVH),total aparoscopic hysterectomy(TAH) and laparotomy hysterectomy.Results: The success rate in four laparoscopic surgical groups were all more than 95%,much higher than the success rate of laparotomy group(87.4%)(P <0.05).The complication rate in four laparoscopic groups were far less than the laparotomy group(P<0.05).There was no significant difference in surgical success rate and complication rate between the four laparoscopic groups(P>0.05).The operation time,blood loss,hospital stay and hospital costs in four laparoscopic groups were also lower than the laparotomy group(P<0.05).But the four laparoscopy groups showed no significant difference with each other(P>0.05).The incidence and duration of systemic inflammatory response syndrome in four laparoscopic groups were lower than in laparotomy group(P<0.05),while there was no statistical difference between the four laparoscopic groups(P >0.05).Conclusions: Laparoscopic hysterectomy is clinical effective,safe and effective,minimally invasive,and with low cost,so it is suitable for patients with the surgical indications.