摘要
目的比较改良阴式子宫切除术(TVH)和腹式子宫切除术(TAV)的临床疗效及其对机体应激反应的影响,探讨改良阴式子宫全切术后的临床应用价值。方法 100例行子宫全切除术患者按手术方式分为阴式组和腹式组,腹式组采用传统的腹式子宫切除术,阴式组采用改良阴式子宫切除术。观察两组手术情况、术后恢复及并发症发生情况,检测两组患者手术前后血清应激反应指标(CPR、IL-6)。结果阴式组手术时间和术中出血量均低于腹式组,相比较差异有显著性(t=5.921、7.654,P<0.01)。阴式组术后排气时间和下床活动时间均低于腹式组,相比较差异有显著性(t=10.017、8.233,P<0.01)。阴式组术后并发症发生率为10.0%,腹式组为28.0%,两组相比较差异有显著性(χ2=5.263,P<0.05)。术后阴式组、腹式组CRP、IL-6水平显著上升,与术前比较均差异有显著性(t=13.794、13.586,19.125、19.402,P<0.05);且术后两组CRP、IL-6水平比较,阴式组显著低于腹式组,相比较差异有显著性(t=11.123、11.978,P<0.01)。结论改良阴式子宫切除术是一种安全、有效的手术方法,可以扩大手术适应证和缩短手术时间,术中出血少、术后体力恢复快,手术对机体的应激反应和创伤小,炎症反应轻,且术后并发症少。
【Objective】 To compare the clinical efficacy and stress responses between patients underwent improved transvaginal hysterectomy（TVH） and transabdominal hysterectomy（TAH）,and explore the clinical value of improved TVH.【Methods】 100 patients underwent hysterectomy were divided into the vaginal group and abdominal group according to the surgical approach.The abdominal group was given the traditional transabdominal hysterectomy,and the vaginal group was given the improved transvaginal hysterectomy.The surgery,postoperative recovery and complications of two groups were observed,the preoperative and postoperative serum stress response indicators（CPR,IL-6） were detected.【Results】 The operative time and blood loss of the vaginal group were lower than the abdominal group,the difference was significant（t =5.921,7.654,P 0.01）.The postoperative exhaust time and ambulation time of the vaginal group were lower than the abdominal group,the difference was significant（t =10.017,8.233,P 0.01）.The postoperative complication rate of the vaginal group was 10.0%,the abdominal group was 28.0%,the difference was significant（χ2=5.263,P 0.05）.The postoperative CRP and IL-6 levels in the vaginal group and abdominal group were significantly increased,there were significant differences between the preoperative and postoperative serum stress response indicators（t =13.794,13.586,19.125,19.402,P 0.05）;And the postoperative CRP and IL-6 levels of vaginal group were significantly lower than the abdominal group,the difference was significant（t =11.123,11.978,P 0.01）.【Conclusion】 The improved TVH is a safety and effective surgical method,which can expand the surgical indications and shorten operative time,reduce bleeding,fasten physical recovery.There are small stress response and trauma on the body,mild inflammatory response and fewer complications using the improved TVH.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2012年第31期97-100,共4页
China Journal of Modern Medicine
关键词
改良阴式子宫切除术
开腹子宫切除术
临床疗效
应激反应
improved transvaginal hysterectomy
transabdominal hysterectomy
clinical efficacy
stress responses
