妇科腹腔镜手术在有腹部手术史患者中的应用

Clincal Analysis of 120 Cases of Gynecologic Laparoscopic Surgery in Patients with History of Abdominal Surgery

目的探讨有腹部手术史患者行妇科腹腔镜手术的可行性、安全性及其优点。方法回顾性分析有腹部手术史行妇科腹腔镜手术的120例患者的临床资料,选择同期同病种无腹部手术史行腹腔镜手术的120例和有腹部手术史行妇科开腹手术的80例患者进行比较研究。结果有手术史组与无手术史组行妇科腹腔镜手术的比较,有手术史组盆腔粘连严重(P<0.01),有显著差异,而中转开腹、并发症、手术时间和出院时间经统计学处理,无显著差异(P>0.05);有手术史妇科腹腔镜组与有手术史妇科开腹手术组比较,腹腔镜组手术时间、下床活动时间和出院时间有显著差异(P<0.01),而出血量和术后病率无显著差异(P>0.05)。结论有腹部手术史行妇科腹腔镜是安全可行的且优于开腹手术。

Objective To investigate the feasibility and security of gynecologic laparoscopy in patients with history of abdominal surgery. Methods A retrospective analysis was made on clinical date of 120 cases of gynecologic laparoscopy in patients with history of abdominal surgery, 80 cases with no history of abdominal surgery as control, from January 2003 to January 2008 in our hospital. Results The pelvic cavity adhesion is serious in group of history surgery, compared in group of no history surgery. And the difference has the significance （P〈0. 01）. The conversion to open surgery, complication,operation time and in hospital time have no significant. （P〉0.05）The difference of operation time , in hospital time and time to leave bed has the significance（P〈0. 01）which in laparoscopy and open surgery group with history of abdominal surgery. The difference of blood loss and postoperative morbidity has no significance（P〉0.05）. Conclusion Gynecologic laparoscopy in patients with history of abdominal surgery is safe and feasible superior to open surgery.