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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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

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

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