基层医院妇科腹腔镜手术并发症探讨及危险因素Logistic回归分析

The Discussion on Complication of Laparoscopic Gynecological Operation in Local Hospital and Logistic Analysis of Risk Factors

目的:探讨基层医院妇科腹腔镜手术并发症原因及危险因素Logistic回归分析。方法:对笔者所在医院2008年2月-2013年2月期间诊治的200例行妇科腹腔镜手术患者临床资料进行回顾性分析,分析手术并发症构成比及相关危险因素。结果:200例患者并发症发生率为17.0%(34/200),其中气腹、穿刺并发症、术中并发症及术后并发症构成比分别为35.3%(12/34)、52.9%(18/34)和11.8%(4/34);有腹部手术史与无腹部手术史患者并发症发生率分别为27.9%(24/86)和8.8%(10/114),比较差异有统计学意义(P<0.05);术者腹腔镜操作时间不足3年者并发症发生率显著高于超过3年者,比较差异有统计学意义(P<0.05);子宫切除术、肌瘤剔除术及附件手术患者并发症发生率分别为35.7%、27.9%、9.3%;Logistic回归分析结果显示手术方式及腹部手术史是手术并发症的危险因素。结论:术中并发症是基层医院妇科腹腔镜手术常见并发症,手术方式及腹部手术史是手术并发症的危险因素。

Objective：To explore the course of complication of laparoscopic gynecological operation in local hospital and Logistic analysis of risk factors. Method：From February 2008 to February 2013,the date of 200 cases undergoing laparoscopic gynecological operation were retrospectively analyzed. The constituent ratio of complications and related risk factors were studied.Result：The occurrence of complications was 17.0%（34/200） among 200 patients. The constituent ratio of complications during insertion of the verres needle and pneumascos,intraoperation and postoperative were 35.3%（12/34）,52.9%（18/34） and 11.8%（4/34）.The complications in patients with or without history of abdominal operation were 27.9%（24/86） and 8.8%（10/114）（P〈0.05）.The higher complications were observed in the doctors whose laparoscopic experience less than 3 years（P〈0.05）.The occurrence of complications in hysterectomy,myomectomy and appendix operation were 35.7%,27.9%and 9.3%（P〈0.05）.Logistic analysis results showed that operation methods and history of abdominal operation were the independence risk factors of complications.Conclusion：Intraoperation complications is the normal complications in the patients undergoing laparoscopic gynecological operation in local hospital. Operation methods and history of abdominal operation are the independence risk factors of complications.