妇科腹腔镜手术并发症分析及预防

Analyzing complications of laparoscopic gynecologic surgery

目的探讨妇科腹腔镜手术并发症的发生原因、处理及预防措施。方法回顾性分析我院1995年9月～2006年6月妇科4413例腹腔镜手术的临床资料。结果4413例妇科腹腔镜手术中,71例出现并发症,发生率为1.6%(71/4413),其中经开腹处理10例,占14.1%(10/71)。并发症包括膀胱损伤5例,肠管损伤4例,出血5例,切口血肿和引流口出血8例,大网膜嵌顿1例,会阴部气肿9例,皮肤淤血12例,头部血肿2例,臂丛神经损伤2例,感染性休克1例,切口愈合不良15例,下肢静脉血栓1例,颈管残端囊肿6例。结论妇科腹腔镜手术并发症与手术难度和术者技巧有关,积极预防可降低其发生率。

Objective To investigate the causes, management, and prevention of complications in laparoscopic gynecologic surgery. Methods A retrospective analysis was made on clinical data of 4413 cases of laparoscopic gynecologic surgery from September 1995 to June 2006 in this hoapital. Results Among 4413 cases, complications occurred in 71 cases, the overall rate being 1.6% （71/4413）. Out of the 71 cases, an open surgery was required in 10 cases （14.1%）. Complications included 5 cases of bladder injury, 4 cases of intestinal injury, 5 cases of massive haemorrhage, 8 cases of incision hematoma and drainage bleeding, 1 case of greater omentum hernia, 9 cases of perineal emphysema, 12 cases of skin congestion, 2 cases of head hematoma, 2 cases of brachial plexus nerve injury, 1 case of infective shock, 15 cases of abnormal incision healing, 1 case of lower limb thrombosis, and 6 cases of residual cervical cyst. Conclusions Complications of laparoscopic gynecologic surgery are correlated with the difficulty of operation and the skillfulness of operator.