Objective: To investigate the surgical techniques and safety of vessel sealing system( LigaSure) and bipolar electrosurgical generator in laparoscopic hysterectomy for enormous uterus. Methods: From Jan. 2008 to Dec. 2013,168 patients with uterine fibroids were selected for the study,all patients were treated with laparoscopic total hysterectomy. Surgical instruments were selected according to patientsu0027 wishes,and according to the surgical equipment used the 168 patients were divided into group A( n = 83,LigaSure and bipolar electric knife) and group B( n = 85,bipolar electrosurgical generator). Conversion to open surgery,operative time,blood loss,postoperative exhaust time,postoperative hospital stay,incidence of postoperative complications were compared between the two groups. Results: In group A the rate of conversion to laparotomy was 3. 6%,and 4. 7% in the group B,the difference was not statistically significant( P 0. 05). The operative time and blood loss of group A were less than those of group B( P 0. 05). The postoperative exhaust time and postoperative hospital stay of two groups was not statistically different( P 0. 05). In group A,1 patient with uterine adenomyosis was found mild extension of left fallopian tube,mild hydronephrosis of the left kidney within 1 week,after anti-inflammatory treatment of 2 weeks,this patient improved and was discharged. Patients in group B did not suffer from serious complications,the difference was not statistically significant( P 0. 05). Conclusions: Using LigaSure and bipolar electric knife in hysterectomy has shorter operative time,less blood loss,and the clinical efficacy is similar with simple use of bipolar electric knife,this procedure can promote the popularization of laparoscopic hysterectomy for enormous uterus.

目的 制作适合去栓治疗的急性肠系膜上动脉栓塞动物模型,研究模型血液学变化.方法 80只成年猪体外制作动物自体血凝块,采用介入方法将自体血凝块注入肠系膜上动脉,造成动脉栓塞,通过腹腔镜观察肠管血运,观察栓塞效果,监测D2聚体及CK.结果 80只实验猪均成功建立急性肠系膜上动脉栓塞致肠缺血模型.栓塞后0.5h、1h、2h腔镜下观察肠管缺血情况,随栓塞时间的延长,肠管损伤逐渐加重,2h时肠管已缺血坏死.栓塞模型建立后CK早期明显升高,12聚体持续上升,并有统计学意义.结论 采用本实验方法可成功建立适合后续去栓治疗研究的急性肠系膜上动脉栓塞动物模型.D2聚体、CK监测,有助于对肠系膜上动脉栓塞诊断.