【正文】 nal of Practical Obstetrics and Gynecology，2002,18(5)：302[7] [J].中華婦產(chǎn)科雜志，2005，40(1)：1316[8] 冷金花，[J].2005，40(1)：5860[9]王剛，謝泳，林鐵成，[J].中國實(shí)用婦科與產(chǎn)科雜志，2006，22(11)：847849[10] Kreiker G L, Bertoldi A, Larcher J s, et evaluation of the learning curve of laparoscopic_assisted vaginal hysterectomy in a university hospital[J].Am Assoc Gynecol Laparoscopy，2004，11:229235[11] Nezhat F, Nezhat C, Ceanal injuries and plications over a 10year period[J].Surg Endo, 1994，8: 533537[12] 鄧姍，[M].北京：人民軍醫(yī)出版社，2008：134135會(huì)陰側(cè)切術(shù)連續(xù)縫合法的臨床觀察來源：作者：陳少平,梁惠萍,李嵐 作者單位：暨南大學(xué)第二臨床醫(yī)學(xué)院深圳市人民醫(yī)院產(chǎn)科，廣東 深圳 518020【摘要】目的：探討會(huì)陰側(cè)切縫合術(shù)采用連續(xù)縫合法的臨床應(yīng)用效果。腹腔鏡手術(shù)是通過電視屏幕上顯示的二維圖像進(jìn)行手術(shù)，缺乏立體感，操作難度大[11]。開腹手術(shù)作為經(jīng)典的手術(shù)方式，最大的優(yōu)點(diǎn)是速度快，對(duì)婦科急腹癥的治療很重要。第三，患者手術(shù)體位取頭高臀低位，腸管腸攀上移，手術(shù)操作對(duì)腸管的干擾小[3]。腹腔鏡組患者較開腹組患者下床活動(dòng)時(shí)間早、術(shù)后胃腸功能恢復(fù)快，其主要原因有：第一，手術(shù)在封閉的腹腔內(nèi)進(jìn)行，腹膜及腸管沒有外界器械、紗墊及手術(shù)醫(yī)生的操作刺激，損傷小，疼痛輕。C，與人體溫度相當(dāng)，此方法可減輕術(shù)后胃腸反應(yīng)及嘔吐等并發(fā)癥[2]。第二，腹腔鏡手術(shù)在封閉的腹腔內(nèi)進(jìn)行，外界干擾少。腹腔鏡手術(shù)術(shù)后胃腸反應(yīng)輕及術(shù)后腹部切口疼痛較傳統(tǒng)開腹手術(shù)輕。第三，人工氣腹形成的正壓力有一定的“壓迫止血”作用。腹腔鏡組患者較開腹組術(shù)中出血少，其主要原因：首先，腹壁穿刺在腹腔鏡透光引導(dǎo)下進(jìn)行，避開腹壁血管。表4兩組術(shù)中及術(shù)后情況表3～4顯示，%，其中有3例中轉(zhuǎn)開腹，開腹組手術(shù)完成率100%。表2兩組患者術(shù)前一般情況兩組患者在年齡、術(shù)前白細(xì)胞、血紅蛋白、血小板方面比較，差異無統(tǒng)計(jì)學(xué)意義(P)。表1腹腔鏡組與開腹組的病例構(gòu)成(%)對(duì)兩組患者疾病構(gòu)成進(jìn)行均衡性檢驗(yàn)，差異無統(tǒng)計(jì)學(xué)意義(χ2=，P=)。 統(tǒng)計(jì)學(xué)處理方法，計(jì)數(shù)資料采用χ2檢驗(yàn)，計(jì)量資料采用獨(dú)立樣本t檢驗(yàn)，顯著性檢驗(yàn)水準(zhǔn)為α=。 觀察指標(biāo)術(shù)中觀察指標(biāo)：手術(shù)完成例數(shù)、手術(shù)時(shí)間和術(shù)中出血量。(5)全面探查盆腔情況，明確病變部位和性質(zhì)，確定具體手術(shù)方法[1]。(3)上提腹壁，將第一戳卡與腹壁皮膚垂直穿刺進(jìn)入腹腔，連接好CO2氣腹機(jī)，置入腹腔鏡，打開冷光源，患者取頭低臀高體位，暴露盆腔內(nèi)臟器。 方法腹腔鏡組：(1)患者取膀胱截石位，留置尿管，放置舉宮器(CT)，在全麻下進(jìn)行手術(shù)。資料與方法 一般資料收集青海大學(xué)附屬醫(yī)院2008年1月至12月婦科住院病人共230例，根據(jù)患者病變及手術(shù)方式的不同將其分為腹腔鏡手術(shù)患者110例(腹腔鏡組)，傳統(tǒng)開腹手術(shù)患者120例(開腹組)。隨著腹腔鏡的出現(xiàn)，一些婦科疾病如卵巢黃體破裂、異位妊娠、盆腔子宮內(nèi)膜異位癥等在不開腹的情況下，得到早期診斷和治療。 and 177。 respectively,。both of them showed statistical differences(Pwas 177。 ml and 177。 respectively。 Affiliated Hospital of Qinghai University)Abstract Objective To pare the gynecological laparoscopic operation and traditional laparotomy one and investigate the advantages and indexes of the gynecological laparoscopic In this study, we randomly divided two groups: laparoscopic group(n=110)and laparotomic group(n=120).The intraoperative and postoperative indexes were observed indexes of the two groups analyzed by SPSS The results showed that operative time of the two groups were 177。)ml，差異有統(tǒng)計(jì)學(xué)意義(P【關(guān)鍵詞】 腹腔鏡手術(shù) 傳統(tǒng)開腹手術(shù) 比較研究LAPAROSCOPIC OPERATION AND TRADITIONALLAPAROTOMY OPERATIONKong Shuang1，Ma Shengxiu2( Yang Second People39。(177。)min、(177。方法 選取婦科腹腔鏡手術(shù)患者110例(腹腔鏡組)和傳統(tǒng)開腹手術(shù)患者120例(開腹組)，分別對(duì)兩組患者術(shù)中及術(shù)后的一些定量及定性指標(biāo)進(jìn)行比較分析。【參考文獻(xiàn)】[1]Mo L，Zheng X，Huang H Y，et of Haras oncogene，but not Ink4a/Arf deficiency，triggers bladder tumorigenesis[J].J Clin Invest，2007，117(2)：314325.[2]Murphy N, Ring M, Killalea A G, et as a marker for cervical dyskaryosis: CIN and cGIN in cervical biopsies and ThinPrep smears [J].Clin (1),56:5663.[3]Haferkamp S, Becker T M, Scurr L L,et (INK4a)induced senescence is disabled by melanomaassociated mutations[J].Aging Cell，2008，7(5)：733745.[4]Bracken A P，KleineKohlbrecher D，Dietrich N，et Polyb group proteins bind throughout the INK4AARF locus andare disassociated in senescent cells[J].Genes Dev，2007，2l(5)：525530.[5]Khoo C 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作者單位：(。p