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目的比较改良大子宫腹腔镜辅助下阴式切除术和传统大子宫腹腔镜辅助下阴式切除术后的近期及远期并发症并探讨预防方法。方法对220例行改良大子宫腹腔镜辅助下阴式切除术(改良组)和116例传统大子宫腹腔镜辅助下阴式切除术(传统组)患者资料进行回顾性分析。比较两组患者近期并发症和远期并发症的发生情况。结果两组近期并发症均以损伤性并发症、阴道残端出血为主。远期并发症中,术后1年、3年比较,传统组便秘的发生率高于改良组(P均<0.05);术后3年传统组尿失禁发生率高于改良组(P<0.01);术后3年传统组性高潮缺失的发生率高于改良组(P<0.05);术后3年传统组阴道穹窿脱垂发生率高于改良组(P<0.01)。结论改良大子宫腹腔镜辅助阴式子宫切除术在保持女性盆底结构和功能方面优于传统大子宫腹腔镜辅助下阴式切除术。
Objective To compare the short-term and long-term complications after modified hysterectomy with large hysteroscope assisted by vaginal resection and traditional hysteroscopic laparoscopic assisted vaginal resection and explore the preventive methods. Methods A retrospective analysis was performed on 220 patients undergoing modified radical hysterectomy with laparoscopic assisted radical mastectomy (modified group) and 116 patients undergoing conventional hysteroscopic laparoscopic assisted vaginal resection (conventional group). The complication and long-term complications of two groups were compared. Results The two groups of recent complications were traumatic complications, vaginal stump bleeding. In the long-term complication, the incidence of constipation in the traditional group was higher than that in the modified group (P <0.05) at 1 year and 3 years after operation. The incidence of urinary incontinence in the traditional group was significantly higher than that in the modified group at 3 years ). The incidence of orgasmic absence in the traditional group was higher than that in the modified group 3 years after operation (P <0.05). The incidence of vaginal vault prolapse in the traditional group 3 years after operation was significantly higher than that in the modified group (P <0.01). Conclusion Improved hysteroscopic laparoscopic assisted vaginal hysterectomy in maintaining female pelvic floor structure and function is superior to the traditional large hysteroscopic laparoscopic assisted vaginal resection.