摘要
目的 比较腹腔镜筋膜内子宫切除术 (Classicintrafascialsupracervicalhysterectomy ,CISH)和剖腹子宫次全切除术的临床效果。 方法 CISH 12 5例 (腹腔镜组 ) ,剖腹子宫次全切除术 6 4例 (剖腹组 ) ,对照分析两组手术及术后情况。 结果 腹腔镜组手术时间 ( 10 2 1± 2 8 9min)与剖腹组 ( 97 7± 2 4 1min)无明显差异 (t =0 78,P >0 0 5 ) ,腹腔镜组术中出血 ( 79 4±5 3 3)ml显著少于剖腹组 ( 99 5± 38 2 )ml(t=2 11,P <0 0 5 ) ,腹腔镜组术后最高体温 ( 37 9± 0 4 )℃明显低于剖腹组 ( 38 4±0 3)℃ (t=2 34,P <0 0 5 ) ,腹腔镜组术后病率 ( 15 2 % )明显低于剖腹组 ( 34 4 % ) ( χ2 =9 16 ,P <0 0 1) ,腹腔镜组术后住院时间 ( 7 8± 2 4 )天明显短于剖腹组 ( 9 5± 3 5 )天 (t=2 6 5 ,P <0 0 1) ,腹腔镜组术后排气时间 ( 2 1± 0 4 )天明显早于剖腹组 ( 2 3± 0 5 )天 (t=2 32 ,P <0 0 5 )。两组并发症发生率无明显差异。 结论 CISH具有手术时间短、术中出血少、术后病率低、术后恢复快等优点 ,尤其适合无明显宫颈病理改变的良性子宫病变患者。
Objective To compare the clinical efficiency of laparoscopic classic intrafascial supracervical hysterectomy (CISH) with that of open supracervical hysterectomy (OSH). Methods A comparison was made between 125 patients undergoing CISH and 64 patients undergoing OSH from May 2000 to July 2001 in this hospital. Results The duration of operation was (102.1±28.9) min in CISH and (97.7±24.1) min in OSH without significant difference (t=0.78, P>0.05). The blood loss was (79.4±53.3) ml and (99.5±38.2) ml in CISH and OSH, respectively (t=2.11, P<0.05). The postoperative peak temperature of patients with CISH was obviously lower than that with OSH (37.9±0.4℃ vs 38.4±0.3℃, t=2.34, P<0.05). The postoperative morbidity was 15.2%(19/125) in CISH and 34.4%(22/64) in OSH, with statistically significant difference between the two groups (χ2=9.16, P<0.01). The postoperative hospital stay was (7.8±2.4) days and (9.5±3.5) days in CISH and OSH, respectively (t=2.65, P<0.01). And the postoperative time to first flatus was significantly shorter in CISH than that in OSH (2.1±0.4 days vs 2.3±0.5 days, t=2.32, P<0.05). No significant difference was seen in respect of complication rate in both groups. Conclusions This study suggests that patients undergoing CISH show shorter operating time, less blood loss, lower postoperative morbidity and better postoperative life quality. CISH is preferred especially in benign uterine diseases without pathologic lesions of cervixes.
出处
《中国微创外科杂志》
CSCD
2003年第2期111-113,共3页
Chinese Journal of Minimally Invasive Surgery
