目的:通过比较腹腔镜下全子宫切除术(total laparoscopic hysterectomy,TLH)和经腹全子宫切除术(total abdominal hysterectomy,TAH),探讨大子宫行TLH的安全性和可行性.方法:收集100例大子宫(子宫≥12周)准备子宫切除的患者,50例行TLH(TLH组);50例行TAH(TAH组),比较2组患者术中与术后并发症发生率、手术时间、术中出血、术后血红蛋白改变、红细胞容积改变.结果:50例行TLH者,无一例中转开腹,术中、术后并发症2组间无显著差异(P>0.5),手术时间TLH组较TAH组长(P<0.01);围术期血红蛋白(Hb)和红细胞容积(Hct)在两组间无显著差异;术中出血量TLH组较TAH组多(P<0.01).结论:大子宫行TLH是安全可行.%Objective:To investigate the effectiveness and safety of total laparoscopic hysterectomy(TLH) for large uterus comparing with total abdominal hystcrcctomy(TAH). Methods: A total of 100 patients with enlarged uterus have been involved in this study. 50 cases of them underwent TLH (TLH group) and the other 50 cases underwent TAH (TAH group) , whether or not adncxectomy was performed. Intraopcrativc and postoperative complication rates, operative time, amount of blood loss, pcriopcrativc hematocrit and hemoglobin concentrations were compared between the two groups. Results; Of the 50 cases who underwent TLH, no case was converted to laparotomy. No difference was found in prcopcrativc and postoperative complication rates between the two groups. The amount of blood loss in the TLH group was significantly more than the TAH group (P0. 05). Conclusions: TLH for large uterus is safe.
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