妇科腹腔镜手术并发症的相关因素分析及处理

Analysis of Risk Factors in 1167 Cases of Gynecologic Laparoscopic Procedures with Complications

目的探讨妇科腹腔镜手术的并发症和相关因素。方法回顾分析1167例妇科腹腔镜手术病例并发症的相关因素及处理结果。结果腹腔镜手术并发症发生率0.94%(11/1167)。附件手术并发症的发生率为0.28%(2/726),肌瘤剔除术为0.98%(2/205),子宫切除术为2.97%(7/236)。穿刺与气腹并发症的发生率为0.34%(4/1167),术中并发症为0.34%(4/1167),术后并发症为0.26%(3/1167)。子宫切除术的并发症发生率高于其他种类手术(P<0.05)。结论妇科腹腔镜并发症的发生主要与手术的难易程度以及医生操作经验有关,了解其并发症的发生原因,加强预防措施,可以降低并发症的发生。

Objective To investigate the occurrence of complications in gynecologic laparoseopic operation and to assess the possible risk factors for the complications. Methods We retrospectively reviewed and analyzed the complica- tion of 1167 cases laparoscopy from year 2004 to 2007. Results The total rate of complication was 0.94% （11/1167）, the rate was 0. 28% （2/726） ,0. 98% （2/205） and 2, 97% （7/236） in adnexal surgery,myomectomy, hysterectomy,re- spectively. The rate of complication related with puncture process and formation of pneumoperitoneum was 0. 34 % （4/ 1167）, that of during operation was 0.34% （4/1167）, that of post-operation was 0.26 % （3/1167）. Compared to other operations,there was a significantly higher rate of complication that need to laparotomy observed in hysterectomy （P% 0.0S）. Conclusions The complications of gynecologic laparoscopy is associated with the difficulty of surgery and the ex- perience of doctor. The rate of complications can be decreased after we learn its causes.