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妇科腹腔镜手术相关并发症及影响因素分析 被引量:15

Analysis of gynecological laparoscopic surgery related complications and influencing factors
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摘要 目的分析妇科腹腔镜手术相关并发症及影响因素。方法选择2009年5月至2014年5月采用腹腔镜下手术方式治疗的患者2 100例作为研究对象,对患者平均年龄、体重指数(BMI)、疾病分类、过往是否进行腹部手术、既往有无子宫内膜异位症病史等临床资料进行分析,探讨妇科腹腔镜手术并发症的影响因素。结果 1患者总的并发症发生率为3.29%(69/2 100),其中气腹及穿刺并发症共6例(0.29%),术中并发症共49例(2.33%),术后并发症共14例(0.67%)。其中Ⅰ、Ⅱ、Ⅲ、Ⅳ类手术的并发症发生率分别为0.97%(15/1 541),5.69%(16/281),7.26%(13/179),25.25%(25/99)。2单因素分析显示,发生并发症患者在子宫大小、手术类别、BMI、子宫内膜异位症病史等因素与未发生并发症患者的比较,差异均有统计学意义(P<0.05)。两组患者年龄、手术史等因素的比较中,差异无统计学意义(P>0.05)。多因素Logistic分析显示,手术类别(OR=6.339)、子宫内膜异位症病史(OR=5.564)是并发症发生的影响因素。结论与妇科腹腔镜术式相关并发症出现有明显关系的临床因素为手术的级别及既往的子宫内膜异位症病史,手术的复杂程度越大、级别越高或者伴有子宫内膜异位症病史的病人其并发症的发生率显著增加。临床实际工作中应充分重视妇科腹腔镜手术相关并发症的相关影响因素,积极采取措施降低并发症发生率。 Objective To analyze the gynecological laparoscopic surgery related complications and influencing factors. Methods 2 100 cases of laparoscopic surgery in Department of Gynecology,the Peopleˊs Hospital of Qijiang District from May 2009 to May 2014 were selected into this study. The clinical data of average age,BMI,classification of diseases,abdominal operation history,endometriosis history were analyzed. The operative complications influence factor of gynecological laparoscopic operation were investigated. Results ①The complications overall incidence of patients is 3. 29%(69/2100),including 6 cases(0. 29%)of pneumoperitoneum and puncture complications,49 cases(2. 33%)of intraop-erative complications,14 cases(0. 67%)of postoperative complications. The complication occurrence rate ofⅠ,Ⅱ,Ⅲ,Ⅳkind operation are 0. 97%(15/1541),5. 69%(16/281),7. 26%(13/179),25. 25%(25/99). ②According to the single factor analysis,the differences of u-terine size,operation kind,BMI,endometriosis history between the patients with complications and patients without complications were statistically significant( P 〈0. 05). The differences of age,operation history between the patients with complications and patients without complications were not statistically significant( P 〉0. 05). According to the Logistic multifactor analysis,the operation kind(OR=6. 339),endometriosis history ( OR=5. 564)were the influence factors of complication incidence rate. Conclusion It is essential to pay attention to the related influencing fac-tors of gynecological laparoscopic surgery related complications in the clinical practice and take relevant measures to reduce the incidence of compli-cations.
作者 李敏
出处 《临床和实验医学杂志》 2015年第11期937-940,共4页 Journal of Clinical and Experimental Medicine
关键词 妇科腹腔镜手术 并发症 影响因素 Gynecological department Laparoscopic surgery Complication Influencing factors
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