65例妇科高龄患者子宫全切术后并发症分析

Analysis of complications after total hysterectomy in 65 gynecologic senile patients

目的分析65例妇科高龄患者子宫全切术后并发症发生情况,为减少其发生采取积极措施提供指导性的帮助。方法回顾性分析65例妇科行子宫全切术治疗的高龄(年龄>70岁)患者围手术期临床资料,观察其并发症发生情况。结果 65例妇科高龄患者行子宫全切术后并发症发生依次为切口愈合不良27.69%(18/65)、肠梗阻13.85%(9/65)、术后感染12.31%(8/65)、下肢静脉血栓9.23%(6/65)、尿潴留1.54%(1/65)、脑梗死1.54%(1/65)。70～74岁患者发生切口愈合不良、肠梗阻的例数多;75～79岁患者发生切口愈合不良、术后感染的例数多;≥80岁患者发生切口愈合不良的例数多。其中75～79岁患者有1例同时发生切口愈合不良及肠梗阻,≥80岁患者有2例同时发生切口愈合不良及术后感染,2例同时发生切口愈合不良及肠梗阻。以上所有并发症经过正规治疗后,均好转,未造成更严重的病情。结论高龄不是妇科手术的绝对禁忌,但仍需严格把握手术指征,积极进行围术期的监控与管理,术后相关并发症均可得到有效防控。

Objective To analyze the occurrence of complications after total hysterectomy in gynecologic senile patients,and provide guidance for reducing the occurrence of complications.Methods The perioperative clinical data of 65 senile patients(age>70 years)underwent total hysterectomy were retrospectively analyzed,and the complications were observed.Results The incidence of complications in 65 elderly gynecologic patients after total hysterectomy were respectively poor incision healing in 27.69%(18/65),intestinal root obstruction in 13.85%(9/65),postoperative infection in 12.31%(8/65),lower extremity venous thrombosis in 9.23%(6/65),urinary retention in 1.54%(1/65)and cerebral infarction in 1.54%(1/65).Incision healing and intestinal obstruction were more common in patients aged 70~74 years,incision healing and infection were more common in patients aged 75~79 years and incision healing was more common in patients≥80 years.Among them,1 case of 75~79 years old patients had incision healing and intestinal obstruction at the same time.2 cases of≥80 years old patients had simultaneous incision healing and postoperative infection,and 2 cases had incision healing and intestinal obstruction.All of the above complications were improved after regular treatment,and did not cause more serious illness.Conclusion Old age is not an absolute contraindication for gynecological surgery,but it is still necessary to strictly control the indications for surgery,and actively monitor and manage in perioperative period.Postoperative complications can be effectively prevented and controlled.