筋膜减张法在妇科腹腔镜手术第一穿刺中的应用

Application of the Method of the Reducing the Fascia Tension in the First Puncture of Gynecological Laparoscopic Surgery

目的为避免妇科腹腔镜手术第一穿刺可能出现的严重并发症腹膜后血管损伤,找到最安全、省力的穿刺方法。方法观察组252例,以筋膜减张法进行的闭合性穿刺,对照组130例按常规闭合性穿刺。筋膜减张法穿刺是在常规闭合性穿刺气腹针形成人工气腹后,用尖刀切开部分筋膜,再穿入穿刺套管。通过分析两组病例穿刺的安全性和易操作性,探索筋膜减张法穿刺的实用价值。结果临床观察组比对照组穿刺更省力,一次成功率高,穿刺深度可控性强。结论在妇科腹腔镜手术中第一穿刺采用筋膜减张法进行闭合性穿刺省力、省时,一次穿刺成功率高,安全可控制性强。更加适用妇科女医生的操作,有推广价值。

Objective To find a most salt and convenient method of puncture avoiding the serious complications ofretroperitoneal vascular injury in the first puncture of gynecologic laparoscopic surgery. Methods 252 cases of the observation group were punctured by the method of reducing fascia tension and 130 cases of the control group were puncyured by the conventional puncture. The puncture of reduc- ing fascia tension was to cut the part of fascia with a sharp knife after the formation of conventional pneumoperitoneum, and then puncture trocar was penetrated. By analyzing the security and maneuverability of the cases in the two groups, the practical value of the method of puncture reducing the fascia tension was to be explored. Results The method of puncture in the observation group was more laborsaving, successful, controllable in first puncture depth than that in the control group. Conclusion The method of puncture reducing the fascia tension is very laborsaving, time-saving, successful, safe and controllable in first puncture of gynecologic laparoscopic surgery, which is more suitable for female gynecologists, and deserves clinical application.