基层医院开展妇科腹腔镜手术可行性分析

Feasibility of gynecological laparoscopic surgery in primary hospitals

目的探讨基层医院开展妇科腹腔镜手术的疗效和安全性。方法回顾性分析该院2007年6月至2011年5月妇科手术993例患者的临床资料,其中腹腔镜手术511例,传统开腹手术482例。从疾病类型、手术指征、手术方式、手术效果、安全性等方面进行分析比较。结果 511例腹腔镜手术患者中顺利完成手术494例(96.67%),中转开腹手术17例(3.33%),发生手术后并发症10例(1.96%)。482例传统开腹手术患者中发生术后并发症12例(2.49%)。腹腔镜手术患者手术时间、术中出血量和术后住院时间均优于传统开腹手术,差异均有统计学意义(P<0.05);而二者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论腹腔镜手术较传统开腹手术具有更好的疗效和优势,减轻了患者痛苦,节约了医院资源,具有较好的可行性,可以在有条件的基层医院中推广应用。

Objective A retrospective analysis is conducted regarding effect and safety of gynecological laparoscopic surgery in grass-roots hospitals. Methods A total of 993 cases were underwent gynecological surgery from June 2007 to May2011 in this hospital,including 511 cases with laparoscopic approach and 482 with traditional surgery. The indicators including disease types,surgical indications,surgical procedures,surgical efficacy and surgical safety were retrospectively analyzed and compared. Results Among 511 cases,494 cases were completed successfully in the laparoscopic surgery,accounting for96.67%,17 cases transferred to laparotomy,accounting for 3.33%,10 cases showed significant complications,accounting for 1.96%.By contrast,among the 482 cases with the traditional surgical approach,12 cases showed significant complications,accounting for2.49%. The operation time,intraoperative blood loss and postoperative hospital stay by laparoscopic approach were superior to those of the traditional operation with statistically significant difference（P〈0.05）,while the incidence of surgical complications after the operation show no significant difference（P〉0.05）. Conclusion The laparoscopic surgery is more better than traditional operation in effect and advantages,alleviating the suffering of patients and saving hospital resources,which is more feasible and could be promoted in conditional grass-roots hospitals widely.