妇科腹腔镜手术常见并发症分析与预防

Prevention and management of major complications after gynecological laparoscopy

目的:分析妇科腹腔镜手术并发症情况及其相关危险因素。方法:对北京海淀医院妇科1998年5月至2006年12月1042例腹腔镜手术及并发症情况进行回顾性分析。结果:本研究中共有29例并发症发生,妇科腹腔镜手术并发症发生率为2.78%(29/1042)。其中包括7例血管并发症,3例膀胱损伤,2例肠管损伤,3例术后感染,2例术后异位妊娠,以及12例其他并发症。腹腔镜辅助阴式子宫切除术及腹腔镜下子宫次全切除术等并发症发生率为1.92%(20/1042),两者比较差异有显著性(P<0.01)。结论:腹腔镜手术广泛应用于治疗各种妇科疾病,手术并发症在可控范围之内。尽管如此,临床医生应该严格掌握腹腔镜手术指征,不要忽视并发症的发生。

Objective： To assess the incidence and type of gynecological laparoscopic complications and associated risk factors. Methods： A total of 1 042 laparoscopic procedures and their complications were analyzed retrospectively from Beijing Haidian Hospital between May 1998 and December 2006. Results： Twenty-nine complications occurred in this series. The overall complication rate after laparoscopy was 2.78 % （29/1 042）. These complications involved seven major vascular complications, three bladder injuries, two intestinal injuries, three postoperative infections, two persistent ectopic pregnancies, and twelve minor complications. Conclusion： Laparoscopic surgery is appropriate for managing various gynecologic diseases and has an acceptable complication rate. However, laparoscopic procedures should be performed carefully because its rate of associated complications should not be underestimated.