摘要
目的:探讨腹腔镜大子宫切除术中经阴道和分碎器取出标本的安全性的比较。方法:回顾性分析2015年2月-2017年12月90例腹腔镜大子宫切除术患者的临床资料,根据手术方法将其分为对照组和观察组,各45例。对照组在子宫完全离断后从分碎器标本取出,观察组在子宫完全离断后从阴道将标本取出。比较两组标本取出成功率、标本取出所需时间、术中出血情况、子宫平均重量、产后排气时间、住院时间及并发症发生情况,以及手术前后患者诺丁汉健康量表(NHP)评分。结果:观察组标本取出成功率和对照组均为100%,比较差异无统计学意义(P>0.05)。所有患者均成功取出标本,未出现取出失败的情况。手术前对照组NHP评分为(45.13±5.21)分,观察组为(45.13±5.43)分,两组NHP评分比较,差异无统计学意义(t=0.141,P>0.05);手术后,观察组NHP评分为(13.24±1.11)分,明显低于对照组的(23.21±9.25)分,差异有统计学意义(t=9.466,P<0.05)。观察组标本取出所需时间为(101.02±2.11)min,明显短于对照组的(124.14±10.21)min,差异有统计学意义(t=8.214,P=0.000);两组术中出血情况、子宫平均重量、产后排气和住院时间比较,差异均无统计学意义(P>0.05)。观察组发热1例,发生率为2.22%;对照组3例,发生率为6.67%,两组并发症发生情况比较,差异无统计学意义(x^2=1.587,P>0.05)。结论:腹腔镜大子宫切除术中经阴道和分碎器取出标本效果相似,但经阴道取出标本可提高操作安全性,减少周围组织损伤风险,缩短标本取出时间,降低子宫肌瘤播散性种植风险,改善患者术后健康水平。
Objective：To investigate the safety of transvaginal and morcellator removal of specimens in laparoscopic large hysterectomy. Method：The clinical data of 90 patients who undergone laparoscopic large hysterectomy from February 2015 to December 2017 were retrospectively analyzed.According to surgical method,they were divided into control group and observation group,45 cases in each group.The control group was removed from the morcellator after the uterus had completely broken off,the observation group was removed from the vagina after the uterus had completely broken off.The successful rate of the specimens removal,the time needed to remove specimens,intraoperative blood loss,the average weight of the uterus,the time of postpartum exhaust and the length of hospital stay,the incidence of complications and the NHP scores before and after surgery were compared between the two groups. Result：The success rate of the specimens removal in the observation group and the control group were both 100%,the difference was not statistically significant（P〈0.05）.All patients were successfully removed specimens and no failure occurred.Before operation,the NHP score of the control group was（45.13±5.21） scores,and the observation group was（45.13±5.43） scores,there was no significant difference in the NHP scores between the two groups（t=0.141,P〈0.05）.After operation,the NHP score of the observation group was（13.24±1.11） scores,which was significantly lower than that of the control group（23.21±9.25） scores,the difference was statistically significant（t=9.466,P〈0.05）.The time needed to remove specimens in the observation group was（101.02±2.11） min,which was significantly shorter than that of the control group（124.14±10.21） min,the difference was statistically significant（t=8.214,P=0.000）.There were no significant differences in intraoperative blood loss,the average uterine weight,the time of postpartum exhaust and the length hospital stay between two groups（P〈0.05）.The fever
作者
郭碧辉
廖再成
廖洁慈
GUO Bihui;LIAO Zaicheng;LIAO Jieci(Huizhou Second Maternal and Child Healthcare Hospital,Huizhou 516001,China)
出处
《中国医学创新》
CAS
2018年第18期29-32,共4页
Medical Innovation of China
基金
惠州市科技计划项目(20170404)
