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目的:比较腹腔镜辅助阴式子宫切除术与腹式全子宫切除术在子宫良性病变的应用效果,为临床治疗提供借鉴。方法:回顾分析金华市中医医院2011年1月-2013年12月接诊的98例子宫良性病变患者病例资料,其中实施腹腔镜辅助阴式子宫切除术组(LAVH组)42例,腹式全子宫切除术组(TAH组)56例,比较两组患者手术时间、术中出血量、术后疼痛、肛门排气恢复时间、住院时间、伤口愈合、术后完成恢复时间,采用放免法检测术后1d、2d的皮质醇、IL-6及CRP水平评价术后应激反应。结果:1LAVH手术时间明显长于TAH组,术中出血量明显少于TAH组,术后疼痛轻于TAH组,肛门排气恢复时间、住院时间、术后完成恢复时间明显短于TAH组,伤口疼痛明显轻于TAH组,P均<0.05。2LAVH组术后1d的IL-6及CRP水平明显低于TAH组,P均<0.05。结论:腹腔镜辅助下阴式子宫切除术有创伤小、安全高、疼痛轻、康复快、腹壁瘢痕小、适应症广的特点,手术应激反应明显小于TAH,临床医师在熟练掌握腹腔镜手术技术下对于符合适应症的患者可作为理想的子宫切除术式。
Objective: To compare the effect of laparoscopic-assisted vaginal hysterectomy and abdominal hysterectomy in the treatment of benign uterine lesions and provide reference for clinical treatment. Methods: A retrospective analysis of 98 cases of benign and malignant uterine lesions admitted to Jinhua Chinese Medicine Hospital from January 2011 to December 2013 was conducted. Among them, 42 cases of laparoscopic assisted vaginal hysterectomy group (LAVH group) Hysterectomy group (TAH group) 56 cases, the operation time, intraoperative blood loss, postoperative pain, anal exhaust time, hospital stay, wound healing, postoperative recovery time were compared between two groups of patients using radiotherapy After 1d, 2d cortisol, IL-6 and CRP levels were evaluated postoperative stress response. Results: The operation time of 1LAVH was significantly longer than that of TAH group. The blood loss during operation was significantly less than that of TAH group. Postoperative pain was less than that of TAH group. The recovery time of anus exhaust, hospitalization time and postoperative recovery time were significantly shorter than those of TAH group. The levels of IL-6 and CRP in the LAD group were significantly lower than those in the TAH group, all P <0.05. Conclusions: Laparoscopic assisted vaginal hysterectomy has the characteristics of small trauma, high safety, light pain, fast recovery, small abdominal wall scarring and wide indications. The surgical stress response is obviously less than that of TAH. Clinicians are good at laparoscopic surgery Under the technology for patients with indications can be used as the ideal hysterectomy.