简介：　　【摘 要】 目的：对比腹腔镜下子宫全切残端经阴道缝合术与开腹子宫全切术的效果。方法：以 2017年 3月至 2019年 12月在本院行子宫全切术治疗的 40例患者作为对象展开研究，根据手术方式将患者分为对照组（ n=20，采用开腹子宫全切术治疗）和观察组（ n=20，采用腹腔镜下子宫全切残端经阴道缝合术治疗）。比较两组患者手术相关情况，同时对患者随访 6个月，比较两组术后并发症发生率，并采用健康调查简表（ SF-36）评价患者术前、术后的生活质量评分。结果：观察组的术中出血量明显少于对照组，阴道排液时间、肛门排气时间、住院时间明显短于对照组（ P<0.05） ;而两组的手术时间比较差异无统计学意义（ P>0.05）。对患者随访 6个月后发现，观察组的残端出血、残端息肉、膀胱阴道瘘、切口愈合不良发生率均明显低于对照组 ;且观察组术后各生活质量评分均显著高于术前和对照组（ P<0.05）。结论：腹腔镜下子宫全切残端经阴道缝合术相比开腹子宫全切术具有创伤小、出血少、恢复快等优势，可有效缩短患者术后康复时间，减少并发症的发生，提高患者预后生活质量。  　　【关键词】 腹腔镜 ;子宫全切术 ;阴道残端 ;开腹 ;经阴道缝合  [Abstract] Objective: To compare the effect of laparoscopic total hysterectomy and open hysterectomy. Methods: 40 patients with hysterectomy in our hospital from March 2017 to December 2019 were selected and divided into control group (n = 20, treated with open hysterectomy) and observation group (n = 20, treated with laparoscopic vaginal suture). The operation related conditions of the two groups were compared, and the patients were followed up for 6 months, the incidence of postoperative complications was compared between the two groups, and the quality of life scores of patients before and after operation were evaluated by SF-36. Results: the intraoperative blood loss of the observation group was significantly less than that of the control group, and the vaginal discharge time, anal exhaust time and hospitalization time were significantly shorter than those of the control group (P < 0.05); however, there was no significant difference in the operation time between the two groups (P > 0.05). After 6 months of follow-up, it was found that the incidence of stump bleeding, stump polyps, vesicovaginal fistula and poor wound healing in the observation group were significantly lower than those in the control group; and the quality of life scores in the observation group were significantly higher than those before operation and in the control group (P < 0.05). Conclusion: compared with open hysterectomy, laparoscopic total hysterectomy with transvaginal suture has the advantages of less trauma, less bleeding and faster recovery, which can effectively shorten the recovery time of patients, reduce the occurrence of complications, and improve the prognosis and quality of life of patients.