725例子宫肌瘤患者三种手术途径行全子宫切除术的临床情况分析

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摘要目的研究子宫肌瘤患者需行子宫切除三种手术途径（开腹、腹腔镜、阴式）全子宫切除术的临床效果。方法回顾性分析2009年9月～2015年1月首都医科大学附属北京妇产医院因子宫肌瘤行全子宫切除患者725例的临床资料，患者分为开腹全子宫切除术组（TAH组，283例）、腹腔镜全子宫切除术组（TLH组，251例）和阴式全子宫切除术组（TVH，191例）三组，分析各组手术时间、术中出血、术后排气时间、术后进食时间、术后体温、并发症及住院时间和住院费用等指标。结果三组比较，TAH组患者术中出血最多，TLH组手术时间最长、住院费用最高，但TLH组术后最高体温、术后排气时间、术后进食时间、术后住院时间及总住院时间均最低，差异有统计学意义（P < 0.05）。TAH、TLH和TVH组并发症发生率比较，差异无统计学意义（P > 0.05）。结论除手术时间略长，住院费用较高以外，TLH在术中出血、术后恢复、术后住院时间和总住院时间等方面均优于TVH、TAH。三种全子宫切除途径各有利弊，临床应根据不同情况选择合适的子宫切除方式。

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	刘雨声张颖段华郭银树▲

关键词 ：全子宫切除术, 子宫肌瘤, 临床效果, 并发症

Abstract：Objective To compare the efficacy of three operative approaches (laparotomy, laparoscopy, vaginal) for hysterectomy in patients with uterine myoma. Methods From September 2009 to January 2015, in Beijing Obstetricsand Gynecology Hospital, Capital Medical University, the clinical data of 725 patients received hysterectomy for uterine myoma were retrospectively analyzed, they were divided into three groups: trans-abdominal hysterectomy group (TAH group, 283 cases), trans-laparoscopic hysterectomy group (TLH, 251 cases) and trans-vaginal hysterectomy group (TVH, 191 cases). The operative time, intraoperative bleeding, postoperative exhaust time, eating time, body temperature, complications, hospitalization time and costs of three groups were compared. Results Three groups were compared, intraoperative bleeding of TAH group was the highest, operative time was the longest, hospitalization costs was the highest, postoperative highest body temperature, exhaust time, eating time, postoperative hospitalization time and total hospitalization time were the lowest, the differences were statistically significant (P < 0.05). The complication rates of three groups were compared, the differences were not statistically significant (P > 0.05). Conclusion TLH is superior to TVH and TAH in terms of intraoperative bleeding, postoperative recovery, hospitalization time and total hospitalization time, except of a longer operative time and higher hospitalization costs. All three hysterectomy approaches have their own advantages and disadvantages, suitable surgical procedure should be chosen according to different condition.

Key words： Hysterectomy Uterine myoma Efficacy Complication

基金资助:北京市医院管理局临床医学发展专项（ZYLX 201406）。

通讯作者: ▲通讯作者

引用本文:

刘雨声张颖段华郭银树▲. 725例子宫肌瘤患者三种手术途径行全子宫切除术的临床情况分析[J]. 中国医药导报, 2017, 14(18): 113-116,120.
LIU Yusheng ZHANG Ying DUAN Hua GUO Yinshu▲. Efficacy of three approaches for hysterectomy in patients with uterine myoma. 中国医药导报, 2017, 14(18): 113-116,120.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2017/V14/I18/113

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