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超声刀在50例腹腔镜子宫肌瘤手术中的应用
作者:张玲玲 夏艳 陈新华 
单位:东南大学医学院附属扬州医院,妇科内窥镜中心,江苏,扬州,225001
关键词:超声刀 腹腔镜 电凝法 子宫肌瘤 手术治疗 
分类号:R730.56, R454.3, R713.4
出版年·卷·期(页码):2003·22·第三期(171-174)
摘要:

目的:评价超声刀用于腹腔镜子宫肌瘤手术的效果。方法:使用超声刀行腹腔镜子宫肌瘤剥除术10例,腹腔镜筋膜内子宫切除术20例,腹腔镜辅助阴式子宫切除(LAVH)术 20例,与使用电凝法行腹腔镜子宫肌瘤剥除术10例及LAVH术20例进行比较。结果:腹腔镜下超声刀手术50例全部完成,电凝法有1例行LAVH术的患者因血管回缩出血多而中转开腹。平均手术时间、平均术中出血量超声刀切瘤组分别为(77.2±22.6)min和(58.3±22.4 ) ml,电凝法切瘤组分别为(120.2±26.1)min和(80.5±16.1)ml,超声刀LAVH术组分别为(102 .2±28.3)min和(86.1±24.1)ml,电凝法LAVH术组分别为(167.3±18.4)min和(160.4±16.6 )ml。结论:超声刀行腹腔镜下子宫肌瘤手术平均手术时间及平均术中出血量均优于腹腔镜电凝术,并可以完全替代之。

Objective  To evaluate the use of the ultrasonically activated scalpel and shears (UASS) in laparoscopic surgery for myoma patients.Methods  50 myoma patients were chosen and divided into 3 groups by different surgerical methods,20 for LAVH,another 20 for CISH,the last 10 for laparoscopic myomectomy(LM).UASS was used to stanch bleeding in these 50 patients.Another 30 myoma patients receiving laparoscopic surgery,were chosen,20 for LAVH,10 for LM.During surgery in these 30 patients electronic coagulating rod and bipolar were used.The average surgerical time and bleeding volume were calculated in different group to compare the efficiency between UASS and electronic coagulating(ECRB).Results  The 50 surgery used UASS were completed smoothly.In ECRB group,1 LAVH patient was performed hysterectomy because of continued bleeding.Average surgerical time (AST) was (77.2±22.6)min,average bleeding volume (ABV) was (58.3±22.4) ml in myomectomy used UASS.AST was (120.2±26.1)min,ABV was (80.5±16.1)ml in myomectomy used ECRB.AST was (102.2±28.3)min,ABV was (86.1±24.1)ml in LAVH used UASS.AST was (167.3±18.4)min,ABV was (  160.4±  16.6)ml in LAVH used ECRB.Conclusion  UASS used in laparoscope for myomectomy is better than ECRB in terms of shortened average surgical time and decreased average bleeding volume.

参考文献:

[1] 孙爱达, 郎景和. 妇科腹腔镜手术的几个技术问题, 1997(5)
[2] 石一复. 腹腔镜下电凝后晚期腹腔内出血致患者死亡一例. 中华妇产科杂志1999(6)
[3] Robbins M L, FERLAND R J. Laparoscopic-assisted vaginal hysterectomy using the laparosonic coagulating shears. 1995(3). doi:10.1016/S1074-3804(5)80120-3
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[5] 喇端端, 郑民华, 沈立翡. 腹腔镜辅助阴式子宫切除术98例分析. 中华妇产科杂志1998(6)
[6] 邵敬於. 标准的经腹腔镜下的SEMM子宫切除术, 1993(1) 

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