选择子宫切除术的途径
Choosing the Route of Hysterectomy.
作者信息
Panda Sandhyasri, Behera Ashok Kumar, Jayalakshmi M, Narasinga Rao T, Indira G
机构信息
Dept. of Obstetrics & Gynaecology, Maharajah's Institute of Medical Sciences, Nellimarla Vizianagaram, 535217 A.P India.
Dept. of Obstetrics & Gynaecology, MKCG Medical College & Hospital, Berhampur, Odisha India.
出版信息
J Obstet Gynaecol India. 2015 Jul;65(4):251-4. doi: 10.1007/s13224-014-0562-z. Epub 2014 May 24.
PURPOSE
To compare the clinical results of three techniques of hysterectomy- abdominal hysterectomy (AH), non-descent vaginal hysterectomy (NDVH), and laparoscopic-assisted vaginal hysterectomy (LAVH).
METHODS
A simple prospective randomized study was performed in a tertiary care centre between June 2011 and Dec 2012, among 150 consecutive women indicated to undergo hysterectomy for benign and mobile uterine conditions. They were randomly assigned 50 each to three routes of hysterectomy; (abdominal, vaginal, and laparoscopic-assisted vaginal). Outcome measures including operating time, blood loss, rate of complications, consumption of analgesics, and length of hospital stay were assessed and compared between groups.
RESULTS
As far as duration of operation, mean blood loss, analgesic requirement, length of hospital stay, P value was significant. Incidence of complications is least among VH group.
CONCLUSION
Vaginal hysterectomy is the gold standard in the era of minimal access surgery. Some of the contraindications to VH can be overcome by assistance of laparoscope and a potential abdominal hysterectomy can be converted to a vaginal procedure.
目的
比较三种子宫切除术技术——腹式子宫切除术（AH）、非脱垂阴道子宫切除术（NDVH）和腹腔镜辅助阴道子宫切除术（LAVH）的临床效果。
方法
2011年6月至2012年12月期间，在一家三级医疗中心对150例因良性且活动的子宫疾病而需接受子宫切除术的连续女性患者进行了一项简单的前瞻性随机研究。她们被随机分为三组，每组50例，分别接受三种子宫切除途径（腹式、阴道式和腹腔镜辅助阴道式）。对包括手术时间、失血量、并发症发生率、镇痛药用量和住院时间在内的结局指标进行评估并在组间进行比较。
结果
就手术持续时间、平均失血量、镇痛需求、住院时间而言，P值具有显著性。阴道子宫切除术（VH）组的并发症发生率最低。
结论
在微创外科手术时代，阴道子宫切除术是金标准。通过腹腔镜辅助可以克服阴道子宫切除术的一些禁忌证，并且有可能将潜在的腹式子宫切除术转变为阴道手术。
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