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目的 探讨腹腔镜下筋膜内子宫切除术 (CISH)的可行性及优越性。方法 对 81例因各种妇科良性病变需行剖腹子宫切除的患者 ,进行腹腔镜下筋膜内子宫切除术 ,与同期随机抽样经腹子宫切除(AH) 81例进行比较。结果 CISH组 79例顺利进行 ,2例中转开腹 ,中转率占 2 .4 7% ,平均手术时间 98.95分钟 ,术中平均出血量 88.0 7ml,术后 3天平均体温 37.6 3℃ ,手术后不需应用止痛药 ,术后住院日中位数4 .2 1天。结论 腹腔镜筋膜内子宫切除术既切除了子宫病灶 ,又保存了盆底的完整性 ;具有不开腹、创伤小、出血少 ,机体应激反应小 ,胃肠功能恢复快 ,术后疼痛轻 ,并发症少 ,术后病率低、恢复快及腹壁美容等优点 ,具有开腹手术无法比拟的优越性 ,是一种较为理想的子宫切除术式
Objective To investigate the feasibility and superiority of laparoscopic intrafascial hysterectomy (CISH). Methods Eighty-one patients undergoing hysterectomy for cesarean section due to various gynecological benign lesions were treated with laparoscopic intrafascial hysterectomy. Compared with 81 cases of randomized abdominal hysterectomy (AH) during the same period. Results In CISH group, 79 cases were successfully performed, 2 cases were converted to open laparotomy, the conversion rate was 2.47%, the average operation time was 98.95 minutes, the mean intraoperative blood loss was 88.0 7ml, the average body temperature 37.6 3 ℃ after 3 days, Painkillers should be used and the median postoperative hospital stay was 4.2 days. Conclusions Laparoscopic intrafascial hysterectomy not only excised the uterine lesions but also preserved the integrity of the pelvic floor. It has the advantages of less laparotomy, less trauma, less bleeding, less stress response, faster recovery of gastrointestinal function and postoperative pain Light, less complications, less postoperative morbidity, faster recovery and the advantages of abdominal wall beauty, with the superiority of open surgery incomparable, is an ideal hysterectomy