摘要
目的探讨应用无气腹腹腔镜行子宫切除术的可行性及优点。方法 2004年10月至2009年10月,选择40例无气腹腹腔镜辅助阴式子宫切除术(无气腹组)与43例气腹腹腔镜辅助阴式子宫切除术(气腹组),比较两组手术时间、术中出血量、术中血气分析、切除的子宫重量、术后病率、抗生素使用时间、住院时间、麻醉费用、手术费用、住院总费用。无气腹组20例患者合并心、肺疾病,为气腹手术禁忌证。结果与气腹组相比,无气腹组手术时间短、术中出血量少、麻醉费用少(P<0.01),但术后使用抗生素时间及住院时间长(P<0.01),术中PaCO2和碱剩余改变差异有统计学意义(P<0.05)。两组术中切除子宫重量、术后病率、手术费用、住院总费用差异无统计学意义(P>0.05)。结论无气腹腹腔镜子宫切除术是可行的,尤其对有心、肺合并症的患者,具有较高的临床应用价值。
Objective To investigate the feasibility and superiority of gasless laparoscopy in hysterectomy. Methods The operation time, blood gas analysis,blood loss, weight of removed uterus, rate of post operative morbidity, time for antibiotics therapy, length of hospitalstay, cost of operation and anesthesia, and total medical cost were compared between gasless laparoscopic hysterectomy （ n = 40 ） andconventi onal laparoscopic hysterectomy （ n = 43 ） , which were performed from October 2004 to October 2009. I n the gasless group, 18 patients were complicated with cardiac ofpulmonaty diseases,which are contraindications of pneumoperitoneum. Results Compared with gasless group, conventional group showed significantly shorter operation time （ P 〈 0.01 ）, Less blood loss （ P 〈 0.01 ） , lower cost for anesthesia （ P〈 0.01 ）, but significantly longer antibiotics therapy （ P〈 0.01 ）, and longer post operative hospital stay （ P〈 0.01 ） ,There were significant differeneses in complications, PaCO2 and BE （ P〈 0.05 ）. No significant difference was found between the two groups in the weight of removed uterus, post operativemorbidity, cost of operation, and total medical cost （ P 〉 0.05 ）. Conclusions Gasless laparoscopy is feasible in hysterectomy, especially for the patients complicated with cardiac or pulmonary diseases.
出处
《中华腔镜外科杂志（电子版）》
2010年第5期45-48,共4页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
关键词
子宫切除术
无气腹
气腹
腹腔镜
血气分析
Hysterectomy
Gasless
Pneumoperitoneum
Laparoscopy
Blood-gas analysis
