妇科腹腔镜手术并发症的临床分析与防治

Clinical analysis,prevention and treatment of complications of laparoscopic surgery in department of gynecology

目的:探讨妇科腹腔镜手术并发症发生的相关因素并提出防治方法。方法:对该院妇科自2005年1月～2009年1月4年间妇科腹腔镜手术患者26例并发症的临床资料及相关因素进行回顾性分析。结果:1860例妇科腹腔镜手术发生并发症26例(1.398%)。其中腹腔镜次全子宫切除术并发症5例,发生率为1.37%(5/366),子宫肌瘤剔除术并发症4例,发生率为2.16%(4/185),辅助阴式子宫切除术9例,发生率为2.80%(9/321),卵巢手术并发症2例,发生率为0.55%(2/361),输卵管妊娠手术并发症6例,发生率为1.85%(6/324)。并发症种类主要子宫穿孔、肩痛、术中出血、血肿和感染等。结论:正确掌握手术适应证,提高操作技巧并改进器械可减少腹腔镜手术并发症的发生。

Objective： To discuss the related factors of complications of laparoscopic surgery and propose preventive measures and treatment. Methods： Clinical data and related factors of complications of laparoscopic sargery in 26 patients from January 2005 to January 2009 were analysed retrospectively. Results： The rate of complications of laparoscopic surgery was 1. 398% （26 cases） , including 5 cases after subtotal laparoscopic hysterectomy （1.37%）, 4 cases after laparoscopic inyomectomy （2. 16% ） , 9 cases after aided vaginal hysterectomy （2. 80% ）, 2 cases after ovarian surgery （0. 55% ） and 6 cases after tubal pregnancy surgery （ 1. 85% ） . The types of complications were perforation of uterus, shoulder pain, intraoperative hemorrhage, haernatoma and infection. Conclusion： Grasping operative indications and enhancing operative skills can reduce the rate of complication of laparoseopic surgery.