妇科腹腔镜手术39例并发症分析

Complications analysis of 39 laparoscopic surgery

目的探讨妇科腹腔镜手术并发症的预防和降低其发生的措施。方法总结2005年6月至2010年6月在北京妇产医院行妇科腹腔镜手术3697例患者的临床资料。结果 3697例中,发生并发症39例,发生率为1.05%。穿刺所致动脉损伤出血5例,占12.82%;与手术相关的并发症14例,占35.90%,其中膀胱损伤4例,输尿管损伤3例,肠管损伤1例,术中出血6例;术后并发症20例,占51.28%,其中术后出血2例,盆腔感染11例,肠梗阻1例,下肢静脉血栓4例,臂丛神经麻痹2例。术中大血管出血、泌尿系及胃肠道损伤等10例中转开腹或再次开腹手术治疗,全部并发症经治疗后预后良好。结论腹腔镜手术虽是微创手术,但仍有发生并发症甚至严重并发症的可能。加强内镜医生手术技能的培训,严格掌握手术适应证可预防和降低并发症的发生。

Objective To analyze the related factors of the complications after laparoscopy surgery and to discover the preventive methods or interventions that could reduce the frequencies. Methods 3697 patients who were underwent laparoscopic surgery from June 2005 and June 2010 were analyzed retrospectively. Results Thirty-nine cases with complications occurred among the 3697 operations （1.05%）, including haemorrhage, urinary system trauma, infection, embolism in veins and subcutaneous emphysema. Conclusions The complications of laparoscopic operation maybe serious. These could occur although the procedure itself is minimally invasive. Improving the performers＇ skill and strictly follow the indications of the procedures are possible measures to prevent or reduce complications.