宫腔镜手术严重并发症的临床分析

Clinical analysis of severe complications of hysteroscopic surgeries

目的:探讨宫腔镜手术严重并发症的诊断、治疗及防治措施。方法:为670例患者施行宫、腹腔镜联合手术,为1 766例患者施行宫腔镜手术。结果:12例发生严重并发症,其中子宫穿孔8例,经观察、保守治疗治愈;出血2例,经宫腔内放置Foley导管、促宫缩治愈;TURP综合征1例,经抢救治愈;空气栓塞1例,经抢救治愈。结论:宫腔镜手术为经验依赖性手术,需要医、护、麻醉良好配合,提高手术技巧,控制手术时间和膨宫液的用量,严密观察,以避免或减少子宫穿孔、空气栓塞、TURP综合征的发生。

Objective：To investigate the diagnosis,treatment and precaution on the severe complications of hysteroscpic surgical procedures. Methods：Six hundreds and seventy cases underwent hysteroscopic surgery and 1 766 cases underwent hysteroscopic comhined with laparoseopic operations. Results： Severe complications occured in 12 cases, among whome 8 cases with uterine perforation were cured by conservative therapy,2 cases with intraoperative haemorrage recovered hy inserting Foley catheter, 1 cases with transurethral resection of prostate（TURP）were rescued hy saline infusion, and 1 case of air emholism was rescued. Conclusions：Hysteroscopy is an experlence-dependent operation. It needs good cooperation between doctor, nurse and anesthetist. Improving the skill of operation, controlling operation time and dosage of distention fluid and careful observation can reduce the incidence of uterine perforation, air embolism and TURP syndrome.