两种腹腔镜辅助下阴式大子宫切除术后近期及远期并发症比较

目的比较改良大子宫腹腔镜辅助下阴式切除术和传统大子宫腹腔镜辅助下阴式切除术后的近期及远期并发症并探讨预防方法。方法对220例行改良大子宫腹腔镜辅助下阴式切除术(改良组)和116例传统大子宫腹腔镜辅助下阴式切除术(传统组)患者资料进行回顾性分析。比较两组患者近期并发症和远期并发症的发生情况。结果两组近期并发症均以损伤性并发症、阴道残端出血为主。远期并发症中,术后1年、3年比较,传统组便秘的发生率高于改良组(P均0.05);术后3年传统组尿失禁发生率高于改良组(P0.01);术后3年传统组性高潮缺失的发生率高于改良组(P0.05);术后3年传统组阴道穹窿脱垂发生率高于改良组(P0.01)。结论改良大子宫腹腔镜辅助阴式子宫切除术在保持女性盆底结构和功能方面优于传统大子宫腹腔镜辅助下阴式切除术。

Near and long-term complications comparison of vaginal hysterectomy of big uterus assisted by two kinds of laparoscopes

Objective To investigate the near and long-term complications and their prevention methods between the improved and traditional vaginal hysterectomies of big uterus assisted by two kinds of laparoscopes. Methods Two hundred and twenty-two cases treated by the vaginal hysterectomies of big uterus assisted by the improved hysterectomy （the improvement group）and 116 cases treated by the vaginal hysterectomies of big uterus assisted by the traditional hysterectomy （ the traditional group） were retrospectively analyzed. The near and long-term complications of the two groups were compared. Results The major near-term complications of the patients in the two groups were the impaired complications and vagina stump hemorrhage. Among long-term complications after one or three years operation, the incidence rate of constipation of the patients in the traditional group was higher than that of improvement group （ P 〈 0.05 ） ;in6idence rate of urinary incontinence of the patients in the traditional group after 3-year operation was higher than that of improvement group（ P 〈0.01 ） ;incidence rate of orgasm depletion of the patients in the traditional group after 3-year operation was higher than that of the improvement group （ P 〈 0.05 ） ; incidence rate of fundus vaginae prolapse of the patients in traditional group after 3-year operation was higher than that of improvement group （ P 〈 0.01 ）. Conclusion The vaginal hysterectomy of big uterus assisted by the improved laparoscope can effectively maintain the structure and function of female pelvic floor.