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目的研究自行研制的经阴道广泛子宫切除术(VRH)手术专用器械应用于该术式的效果及价值。方法选择佛山市妇幼保健院2004年3月至2012年8月因宫颈癌和子宫内膜癌行经阴道广泛性子宫切除术联合腹腔镜盆腔淋巴结切除术患者90例为研究对象,随机分为研究组58例(术中使用专用手术器械),对照组32例(术中使用常规手术器械),按类同的方法进行手术,观察手术完成情况,对手术时间、术中出血量、分离输尿管时间、术中术后并发症、术后排气时间、术后恢复自主排尿时间、术后住院时间等指标进行比较。结果研究组VRH手术成功率100%,对照组VRH手术成功率96.88%,1例中转开腹。研究组平均手术时间、平均出血量、分离输尿管时间及术后排气时间均显著少于对照组,差异有统计学意义(P<0.01),两组术后膀胱功能恢复时间及术后住院时间差异无统计学意义(P>0.05)。研究组无术中泌尿系统损伤发生,对照组有膀胱损伤1例,输尿管损伤1例。结论 VRH专用器械的使用,有效的降低了经阴道广泛子宫切除术的手术难度,减少了术中、术后并发症的发生,值得推广应用。
Objective To study the effect and value of self-developed special equipment for vaginal extensive hysterectomy (VRH) surgery. Methods Select maternal and child health care hospital from March 2004 to August 2012 due to cervical cancer and endometrial cancer underwent vaginal extensive hysterectomy combined with laparoscopic pelvic lymphadenectomy in patients with 90 cases were randomly divided into study group 58 cases (intraoperative use of special surgical instruments), the control group of 32 cases (intraoperative use of conventional surgical instruments), according to the same method of surgery to observe the completion of the operation, the operation time, intraoperative bleeding, ureter time, Postoperative complications, postoperative exhaust time, postoperative autonomic urination time, postoperative hospital stay and other indicators were compared. Results The successful rate of VRH surgery was 100% in the study group, 96.88% in the control group, and 1 case was converted to laparotomy. The mean operative time, mean amount of bleeding, ureter separation time and postoperative exhaust time in the study group were significantly less than those in the control group (P <0.01). The postoperative recovery time of bladder function and postoperative hospital stay The difference was not statistically significant (P> 0.05). The study group had no intraoperative urinary tract injury, while the control group had 1 case of bladder injury and 1 case of ureteral injury. Conclusion The use of VRH special instruments effectively reduces the difficulty of transvaginal hysterectomy and reduces the occurrence of intraoperative and postoperative complications, which is worth popularizing and applying.