腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤的效果观察
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摘要
目的研究腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤的效果。方法选择重庆市巴南区人民医院在2016年5月至2017年5月收治的100例巨大子宫肌瘤患者精心观察,随机将患者而分为对照组50例及治疗组50例。为对照组患者实施传统开腹子宫切除术,治疗组患者使用腹腔镜辅助阴式全子宫切除术,对比两组两组患者的手术情况及一般情况。结果治疗组患者的手术、住院、下床活动、术后排气的时间及术中出血量、抗生素使用时间分别为(117. 2±21. 25) min、(5. 23±1. 02) d、(1. 71±0. 58) d、(23. 54±9. 52) h、(118. 25±65. 23) ml、(1. 51±0. 11) d,对照组患者的手术时间、住院时间、下床活动时间、术后排气时间、术中出血量、抗生素时间分别为(131. 23±20. 12) min、(7. 52±1. 02) d、(2. 25±0. 70) d、(45. 16±10. 25) h、(145. 36±72. 36) ml、(3. 62±1. 52) d,以此表示治疗组患者手术一般情况、抗生素使用及手术排气时间都短与对照组,并且治疗组患者术中出血量比对照组少,数据差异具有统计学意义(P <0. 05)。对照组患者切口感染和皮下气肿的发生情况为5(10%)、4(8%),治疗组患者切口感染和皮下气肿的发生情况为1(2%)、1(2%),明显治疗组患者并发症比对照组低,差异具有统计学意义(P <0. 05)。结论在对巨大子宫肌瘤治疗的过程中,使用腹腔镜辅助阴式全子宫切除术能够缩短手术时间,使患者尽早出院,降低患者出血量,值得临床推广使用。
Objective To study the effect of laparoscopically assisted vaginal hysterectomy in the treatment of gigantic hysteromyoma. Methods 100 patients with gigantic hysteromyoma admitted in our hospital from May2016 to May 2017 were selected and randomly divided into treatment group and control group,with 50 patients in each group. Control group received conventional laparotomy hysterectomy,and the treatment group received laparoscopically assisted vaginal hysterectomy. Operation time,length of hospital stay,ambulation time,postoperative exhaust time,intraoperative blood loss and antibiotics administration time of the two groups were compared. Results Operation time,length of hospital stay,ambulation time,postoperative exhaust time,intraoperative blood loss and antibiotics administration time of treatment group were( 117. 2 ± 21. 25) min,( 5. 23 ± 1. 02) d,( 1. 71 ± 0. 58)d,( 23. 54 ± 9. 52) h,( 118. 25 ± 65. 23) ml,and( 1. 51 ± 0. 11) d respectively,and they were respectively( 131. 23 ± 20. 12) min,( 7. 52 ± 1. 02) d,( 2. 25 ± 0. 70) d,( 45. 16 ± 10. 25) h,( 145. 36 ± 72. 36) ml and( 3. 62 ± 1. 52) d accordingly in control group. The operation time,length of hospital stay,antibiotics administration time and postoperative exhaust time of treatment group were shorter than those of control group,and the intraoperative blood loss of treatment group was less than that of control group,with statistically significant differences( P < 0. 05). The rates of wound infection( 10%) and subcutaneous emphysema( 8%) in control group were significant higher than these of treatment group respectively [( 2%),( 2 %) ]( P < 0. 05). Conclusions In the treatment of gigantic hysteromyoma,laparoscopic assisted vaginal hysterectomy can shorten the operation time and hospital stay,and reduce intraoperative blood loss,which is worth clinical promotion.
Objective To study the effect of laparoscopically assisted vaginal hysterectomy in the treatment of gigantic hysteromyoma. Methods 100 patients with gigantic hysteromyoma admitted in our hospital from May2016 to May 2017 were selected and randomly divided into treatment group and control group,with 50 patients in each group. Control group received conventional laparotomy hysterectomy,and the treatment group received laparoscopically assisted vaginal hysterectomy. Operation time,length of hospital stay,ambulation time,postoperative exhaust time,intraoperative blood loss and antibiotics administration time of the two groups were compared. Results Operation time,length of hospital stay,ambulation time,postoperative exhaust time,intraoperative blood loss and antibiotics administration time of treatment group were( 117. 2 ± 21. 25) min,( 5. 23 ± 1. 02) d,( 1. 71 ± 0. 58)d,( 23. 54 ± 9. 52) h,( 118. 25 ± 65. 23) ml,and( 1. 51 ± 0. 11) d respectively,and they were respectively( 131. 23 ± 20. 12) min,( 7. 52 ± 1. 02) d,( 2. 25 ± 0. 70) d,( 45. 16 ± 10. 25) h,( 145. 36 ± 72. 36) ml and( 3. 62 ± 1. 52) d accordingly in control group. The operation time,length of hospital stay,antibiotics administration time and postoperative exhaust time of treatment group were shorter than those of control group,and the intraoperative blood loss of treatment group was less than that of control group,with statistically significant differences( P < 0. 05). The rates of wound infection( 10%) and subcutaneous emphysema( 8%) in control group were significant higher than these of treatment group respectively [( 2%),( 2 %) ]( P < 0. 05). Conclusions In the treatment of gigantic hysteromyoma,laparoscopic assisted vaginal hysterectomy can shorten the operation time and hospital stay,and reduce intraoperative blood loss,which is worth clinical promotion.
引文
[1]徐旗隅.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤的效果观察[J].中国现代药物应用,2014,21(6):64-65.
[2]王楠,章根琴.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤的临床效果观察[J].中国基层医药,2017,24(11):58-59.
[3]朱琴,陈丹.子宫肌瘤患者不同腹腔镜手术方式子宫切除的疗效、卵巢功能及患者性功能状况的临床研究[J].中国性科学,2017,26(8):42-45.
[4]韩雪,金玲,孙鸿.不同方式子宫切除术治疗子宫肌瘤的疗效对比及对性功能的影响[J].中国性科学,2017,26(9):68-70.
[5]甄文明,谭燕玲,邹岚.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤临床研究[J].当代医学,2011,17(18):69-70.
[6]罗小丹.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤的疗效观察[J].中国医药指南,2013(21):427-428.
[7]谢家滨.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤疗效观察[J].海南医学,2012,23(11):31-32.
[8]刘贯生.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤临床研究[J].吉林医学,2014(19):4261-4262.
[9]刘艳.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤临床研究[J].中国实用医药,2013,8(26):108-109.
[10] Luo B. The application of clinical perioperative nursing pathway in patients who received laparoscope assisted vaginal hysterectomy[J].Journal of Qiqihar University of Medicine,2014,15(5):85-86.
[11]佟宝莉.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤临床观察[J].中国保健营养旬刊,2014(5):2842-2843.
[12] Yang B. Therapeutic effect analysis of improved laparoscopeassisted vaginal hysterectomy in the resection of big uterus[J]. Journal of Minimally Invasive Medicine,2014,17(9):19-20.
[13]陈海青.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤的临床疗效[J].世界最新医学信息文摘,2015,15(73):11-12.
[14]王清平,张慧.阴式子宫切除术在子宫肌瘤中的应用及术后生活质量分析[J].中国性科学,2016,25(6):32-34.
[15]郑蕊.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤临床分析[J].中国实用医药,2014(32):25-26.
[16] Kuang H,Zhu L,Peng X. Effect of laparoscope-assisted vaginalhysterectomy on ovarian function in mid-aged and young women[J]. Journal of Clinical Medicine in Practice,2013,25(15):87-88.
[17]何莎,刘灵霞,王亚宁,等.腹腔镜辅助阴式手术在早期子宫内膜样腺癌中的应用观察[J].中国性科学,2016,25(3):43-46.
[18] Yuan G,Li B,Ke L,et al. Clinical analysis of modified laparoscope assisted vaginal hysterectomy[J]. Journal of Clinical Medicine in Practice,2012,12(11):52-53.
[2]王楠,章根琴.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤的临床效果观察[J].中国基层医药,2017,24(11):58-59.
[3]朱琴,陈丹.子宫肌瘤患者不同腹腔镜手术方式子宫切除的疗效、卵巢功能及患者性功能状况的临床研究[J].中国性科学,2017,26(8):42-45.
[4]韩雪,金玲,孙鸿.不同方式子宫切除术治疗子宫肌瘤的疗效对比及对性功能的影响[J].中国性科学,2017,26(9):68-70.
[5]甄文明,谭燕玲,邹岚.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤临床研究[J].当代医学,2011,17(18):69-70.
[6]罗小丹.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤的疗效观察[J].中国医药指南,2013(21):427-428.
[7]谢家滨.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤疗效观察[J].海南医学,2012,23(11):31-32.
[8]刘贯生.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤临床研究[J].吉林医学,2014(19):4261-4262.
[9]刘艳.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤临床研究[J].中国实用医药,2013,8(26):108-109.
[10] Luo B. The application of clinical perioperative nursing pathway in patients who received laparoscope assisted vaginal hysterectomy[J].Journal of Qiqihar University of Medicine,2014,15(5):85-86.
[11]佟宝莉.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤临床观察[J].中国保健营养旬刊,2014(5):2842-2843.
[12] Yang B. Therapeutic effect analysis of improved laparoscopeassisted vaginal hysterectomy in the resection of big uterus[J]. Journal of Minimally Invasive Medicine,2014,17(9):19-20.
[13]陈海青.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤的临床疗效[J].世界最新医学信息文摘,2015,15(73):11-12.
[14]王清平,张慧.阴式子宫切除术在子宫肌瘤中的应用及术后生活质量分析[J].中国性科学,2016,25(6):32-34.
[15]郑蕊.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤临床分析[J].中国实用医药,2014(32):25-26.
[16] Kuang H,Zhu L,Peng X. Effect of laparoscope-assisted vaginalhysterectomy on ovarian function in mid-aged and young women[J]. Journal of Clinical Medicine in Practice,2013,25(15):87-88.
[17]何莎,刘灵霞,王亚宁,等.腹腔镜辅助阴式手术在早期子宫内膜样腺癌中的应用观察[J].中国性科学,2016,25(3):43-46.
[18] Yuan G,Li B,Ke L,et al. Clinical analysis of modified laparoscope assisted vaginal hysterectomy[J]. Journal of Clinical Medicine in Practice,2012,12(11):52-53.