[1]宋华,邬绍新,张俏,等.腹腔镜全子宫切除术2种阴道断端缝合法的比较[J].中国微创外科杂志,2018,18(3):202-208.
　Song Hua,Wu Shaoxin,Zhang Qiao,et al.Comparison of Two Vaginal Stump Suture Methods for Total Laparoscopic Hysterectomy[J].Chinese Journal of Minimally Invasive Surgery,2018,18(3):202-208.
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腹腔镜全子宫切除术2种阴道断端缝合法的比较()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年3期
页码:
202-208
栏目:
临床论著
出版日期:
2018-05-01

文章信息/Info

Title:
Comparison of Two Vaginal Stump Suture Methods for Total Laparoscopic Hysterectomy
作者:
宋华; 邬绍新; 张俏; 李艺扬**①
吉林省前卫医院妇产科，长春130012
Author(s):
Song Hua;  Wu Shaoxin;  Zhang Qiao;  et al.
Department of Obstetrics and Gynaecology, Qianwei Hospital of Jilin Province, Changchun 130012, China
关键词:
吸耳球; 腹腔镜; 全子宫切除术; 阴道残端缝合
Keywords:
Rubber pipette bulb; Laparoscopy; Total hysterectomy; Vaginal cuff suture
文献标志码:
A
摘要:
目的探讨改进的吸耳球在腹腔镜全子宫切除术阴道断端缝合中的应用价值。方法我院2013年9月~2016年12月在腹腔镜全子宫切除术中应用改进的吸耳球进行阴道断端缝合202例（观察组），与2012年1月~2013年9月传统方法（将无菌纱布放入一次性医用无菌手术手套中，填塞到阴道内）缝合阴道断端95例（对照组）进行比较，观察2组手术时间、出血量、术后排气时间、住院时间等指标。结果观察组手术时间(79.7±20.4)min，明显短于对照组(101.2±301)min（t=-7.224, P=0.000)；术中出血量（88.8±47.6）ml，明显少于对照组（115.4±56.2）ml（t=-4.234, P=0000)；观察组无术后并发症发生，明显少于对照组4例（P=0.010)；观察组术后排气时间（39.5±9.8）h，与对照组排气时间（40.4±13.7）h，无统计学差异（t=-0.646，P=0.519）；2组住院时间分别为（5.2±1.5）d和（5.6±2.1）d，无统计学差异（t=-0.876，P=0.062）。结论腹腔镜全子宫切术中应用改进的吸耳球使阴道断端视野暴露清楚，使原本复杂的缝合变得容易，明显缩短手术时间，术中出血量减少，降低术后并发症的几率，值得推广使用。
Abstract:
ObjectiveTo investigate the value of vaginal cuff suture with modified rubber pipette bulb for total laparoscopic hysterectomy.MethodsA total of 297 patients underwent total laparoscopic hysterectomy for gynecologic diseases from January 2012 to December 2016. Among them, 95 cases received traditional vaginal cuff suture (vagina filled with a disposable surgical operation glove packing with sterile gauze) from January 2012 to September 2013 (control group), and the other 202 cases received vaginal cuff suture with use of modified rubber pipette bulb from September 2013 to December 2016 (observation group). The operative time, blood loss, first anal exhaust time, and hospital stay were compared.ResultsThere was a shorter operative time ［(79.7±20.4) min vs. (101.2±30.1) min, t=-7.224, P=0.000］ and less blood loss ［(88.8±47.6) ml vs. (115.4±56.2) ml, t=-4.234, P=0.000］ in the observation group than those in the control group. Four patients in the control group developed postoperative complications, whereas no complication occurred in the observation group (P=0.010). There was no difference in the first anal exhaust time and hospital stay between the two groups ［(39.5±9.8) h vs. (40.4±13.7) h, t=-0.646, P=0.519; (52±1.5) d vs. (5.6±2.1) d, t=-0.876, P=0.062］.ConclusionsThe application of modified rubber pipette bulb for laparoscopic total hysterectomy has many advantages such as good exposure of vaginal cuff, simple procedure of suture, less blood loss, short operative time, and low incidence of postoperative complications. It is worthy of widespread use.

参考文献/References:

[1]尚慧玲，李光仪，韩玉斌，等．腹腔镜全子宫切除1006例分析．实用妇产科杂志，2006，22(9):579-581．
[2]Dubois PE, Putz L, Jamart J, et al. Deep neuromuscular block improves surgical conditions during laparoscopic hysterectomy: A randomised controlled trial.Eur J Anaesthesiol,2014,31(8):430-436.
[3]张魁，周建兴，任睿，等.腹腔镜辅助下阴式大子宫切除术与开腹大子宫切除术的比较研究.中国微创外科杂志,2012,12(9):802－804．
[4]Walsh CA, Walsh SR, Tang TY, et al. Total abdominal hysterectomy versus total laparoscopic hysterectomy for benign disease: a metaanalysis. Eur J Obstet Gynecol Reprod Biol,2009,144(1):3-7.
[5]Jacoby VL, Autry A, Jacobson G, et al. Nationwide use of laparoscopic hysterectomy compared with abdominal and vaginal approaches. Obstet Gynecol,2009,114(5):1041-1048.
[6]Siedhoff MT, Yunker AC, Steege JF. Decreased incidence of vaginal cuff dehiscence after laparoscopic closure with bidirectional barbed suture. J Minim Invasive Gynecol,2011,18(2):218-223.
[7]Terai Y, Tanaka T, Sasaki H, et al. Total laparoscopic modified radical hysterectomy with lymphadenectomy for endometrial cancer compared with laparotomy. J Obstet Gynaecol Res,2014,40(2):570-575.

备注/Memo

备注/Memo:
基金项目：吉林省卫生计生适宜技术推广项目（2016S019）**通讯作者，E-mail： 2475054014@qq.com①(吉林大学第一医院妇产科，长春130021）
更新日期/Last Update: 2018-05-10