不同手术方式对全子宫切除术患者临床疗效术后疼痛和安全性的影响

doi:10.3969/j.issn.1006-6233.2025.08.028

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摘要目的:探讨全子宫切除术患者采用不同手术方式的临床效果。方法:回顾性分析本院于2021年1月至2023年12月收治的行全子宫切除术患者的相关临床资料,依据排纳标准共纳入113例患者作为研究对象,并依据术式分为腹式全子宫切除术(TAH)组(46例)、阴式全子宫切除术(TVH)组(48例)、腹腔镜辅助阴式全子宫切除术(LAVH)组(19例)。比较TAH组、TVH组、LAVH组基线资料、临床指标、术后视觉模拟评分法(VAS)评分、术后并发症。结果:LAVH组手术时间长于TAH组、TVH组,且术后LAVH组下床、住院及肛门排气时间均短于TAH组、TVH组,且TVH组下床、住院及肛门排气时间均短于TAH组差异有统计学意义(P<0.05);TVH组(4例)、LAVH组(2例)使用镇静剂率分别8.33%、10.53%,均低于TAH组(29例)的78.26%(P<0.05);术后LAVH组24h与48h VAS评分均低于TAH组、TVH组,且TVH组24h与48hVAS评分低于TAH组(P<0.001);术后TVH组(2例)、LAVH组(1例)并发症发生率分别4.16%、5.26%,低于TAH组(9例)的19.56%(P<0.05)。结论:TVH与LAVH两种术式均具备良好的安全性,相较TAH、TVH而言,LAVH更微创,可促使患者恢复进程加快,让患者可尽早出院。

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关键词 ：全子宫切除术, 腹腔镜, 腹式子宫切除术, 阴式子宫切除术, 疼痛程度, 安全性

Abstract：Objective: To investigate the clinical effects of different surgical methods on patients undergoing total hysterectomy. Methods: Relevant clinical data of patients undergoing total hysterectomy in the hospital were retrospectively analyzed between January 2021 and December 2023, and a total of 113 patients were included as study subjects according to the exclusion criteria and divided into total abdominal hysterectomy (TAH) group (46 cases), total vaginal hysterectomy (TVH) group (48 cases) and laparoscopic assisted vaginal hysterectomy (LAVH) group (19 cases). The baseline data, clinical indicators, postoperative Visual Analogue Scale (VAS) score and postoperative complications were compared among TAH group, TVH group and LAVH group. Results: The surgical time in the LAVH group was longer than that in the TAH group and the TVH group, and the ambulation time, hospitalization time and anal exhaust time in the LAVH group after surgery were shorter than those in the TAH group and the TVH group, and the above indicators were shorter in the TVH group than those in the TAH group (P<0.05). The sedative use rate was 8.33% in the TVH group (4 cases) and was 10.53% in the LAVH group (2 cases), which was lower than 78.26% in the TAH group (29 cases) (P<0.05). The VAS scores in the LAVH group at 24 and 48 hours after surgery were lower than those in the TAH group and the TVH group, and the above scores in the TVH group were lower compared with those in the TAH group (P<0.001). The incidence of postoperative complications after surgery was 4.16% in the TVH group (2 cases) and 5.26% in the LAVH group (1 case), which was lower than 19.56% in the TAH group (9 cases) (P<0.05). Conclusion: Both TVH and LAVH have good safety. Compared with TAH and TVH, LAVH is more minimally invasive, which can accelerate the recovery process of patients and enable patients to be discharged as soon as possible.

Key words： Total hysterectomy Laparoscopic Abdominal hysterectomy Vaginal hysterectomy Pain degree Safety

基金资助:2020年度安徽省自然科学基金项目,(编号:2008085QH387)

引用本文:

王湘琼, 蒋业忠, 王维平, 马红梅, 曲雪青. 不同手术方式对全子宫切除术患者临床疗效术后疼痛和安全性的影响[J]. 河北医学, 2025, 31(8): 1386-1391.
WANG Xiangqiong, JIANG Yezhong, WANG Weiping, et al. Influences of Different Surgical Methods on Clinical Efficacy Postoperative Pain and Safety in Patients with Total Hysterectomy. HeBei Med, 2025, 31(8): 1386-1391.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.08.028 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I8/1386

[1] Pickett CM,Seeratan DD,Mol BWJ,et al.Surgical approach to hysterectomy for benign gynaecological disease[J].Cochrane Database Syst Rev,2023,8(8):3677.
[2] 中国妇幼保健协会妇科阴式手术专业委员会,柳晓春,黄晓斌,等.经阴道全子宫切除术专家共识(2024年版)[J].中国实用妇科与产科杂志,2024,40(3):321-328.
[3] Wang J,Liu G,Yang Q.Parasitic myoma after transabdominal hysterectomy for fibroids:a case report[J].BMC Womens Health,2023,23(1):310.
[4] Giannini A,D'Oria O,Vizza E,et al.Robotic-assisted,laparoscopic,and vaginal hysterectomy in morbidly obese patients with endometrial hyperplasia and endometrial cancer[J].Minim Invasive Ther Allied Technol,2024,33(6):358-364.
[5] Ioana JTM,Voita-Mekeres F,Motofelea AC,et al.Surgical outcomes in laparoscopic hysterectomy,robotic-assisted,and laparoscopic-assisted vaginal hysterectomy for uterine and cervical cancers:a systematic review[J].Diagnostics (Basel),2024,14(24):2782.
[6] Chakraborty N,Rhodes S,Luchristt D,et al.Is total laparoscopic hysterectomy with longer operative time associated with a decreased benefit compared with total abdominal hysterectomy[J].Am Obstet Gynecol,2023,228(2):1-12.
[7] Casarin J,Ielmini M,Cromi A,et al.Post-traumatic stress following total hysterectomy for benign disease:an observational prospective study[J].Psychosom Obstet Gynaecol,2022,43(1):11-17.
[8] Del Boca G,Damiani GR,Zagni R,et al.Total laparoscopic hysterectomy four-handed ergonomic technique:description of an original surgical procedure for the reduction of learning curve[J].Minerva Obstet Gynecol,2023,75(3):298-306.
[9] Alcazar JL,Vara J,Usandizaga C,et al.Transvaginal ultrasound versus magnetic resonance imaging for diagnosing adenomyosis:a systematic review and head-to-head meta-analysis[J].Int Gynaecol Obstet,2023,161(2):397-405.
[10] Lenfant L,Canlorbe G,Belghiti J,et al.Robotic-assisted benign hysterectomy compared with laparoscopic,vaginal,and open surgery:a systematic review and meta-analysis[J].Robot Surg,2023,17(6):2647-2662.
[11] Zeng Z,Liu J,Lv T,et al.Evaluation of the efficacy of laparoscopic-assisted radical vaginal hysterectomy and abdominal radical hysterectomy for treating cervical cancer:a meta-analysis[J].Wideochir Inne Tech Maloinwazyjne,2022,17(1):69-82.