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目的 探讨阴式子宫切除手术的操作技巧 ,提高手术水平。方法 借助器械LigaSureTM行阴式全子宫、附件切除术 (LigaSureTM组 ) 15 5例 ,与我院同期由同一医疗组医生以传统手术方式完成的阴式全子宫附件切除术 (传统组 ) 15 5例进行临床对照分析 ,探讨阴式子宫切除手术中的微创效果。结果 从环切阴道壁至缝闭阴道残端LigaSureTM组手术时间最长 4 0min、最短 8min ;术中出血量最多 115ml,最少 10ml;术后平均住院日5d ;术后 3个月复查阴道残端 ,无线头及肉芽生成 ,愈合良好 ,患者阴道分泌物正常。传统组手术时间最长 70min ,最短 15min ;术中出血量最多 5 0 0ml,最少 2 0ml;术后平均住院日 6 99d ;术后 3个月复查阴道残端 ,部分患者有线头及肉芽生成 ,间断出现血性分泌物或伴有异味 ,影响生活质量。比较手术时间、术中出血、术后并发症 (术后 3个月阴道残端情况 ) ,LigaSureTM组明显优于传统组 (P <0 0 5 )。结论 借助器械切除子宫附件使术中操作难度明显降低 ,简化了操作步骤 ,减少了副损伤 ,明显减少了术中出血及缩短了手术时间 ,术后恢复更快 ,达到了微创的目的 ,使阴式手术切除子宫更易掌握 ,便于广泛推广。
Objective To explore the operation skills of vaginal hysterectomy and improve the operation level. Methods One hundred and fifty-five cases of vaginal total hysterectomy (LigaSureTM group) were performed with the LigaSureTM apparatus and 15 5 cases of vaginal total hysterectomy (traditional group) performed by the same medical team with the same medical department during the same period of our hospital. Clinical control analysis to explore the minimally invasive vaginal hysterectomy results. Results LigaSureTM group had the longest operation time of 40 min and the shortest duration of 8 min from the vaginal wall to the closed vaginal stump. The mean amount of blood loss during operation was 115 ml and the minimum was 10 ml. The average postoperative hospital stay was 5 days. , Wireless head and granulation formation, healed well, the patient’s vaginal secretions normal. The traditional operation time was the longest 70min, the shortest 15min; intraoperative blood loss up to 500ml, at least 20ml; average postoperative hospital stay 699d; 3 months after the review of the vaginal stump, some patients with thread and granulation, Intermittent bloody discharge or accompanied by bad smell, affecting the quality of life. Comparing operative time, intraoperative bleeding and postoperative complications (vaginal stump 3 months after operation), LigaSureTM group was significantly better than the traditional group (P <0 05). Conclusions The removal of uterine accessory by means of instruments can reduce the difficulty of intraoperative operation, simplify the operation procedure, reduce the secondary injury, significantly reduce the intraoperative bleeding and shorten the operation time, achieve faster postoperative recovery and achieve the purpose of minimally invasive surgery. Vaginal surgical removal of the uterus easier to grasp, to facilitate the widespread.