【摘要】 目的 分析妇科腹腔镜手术并发症的发生原因,探讨降低并发症发生率的预防措施。方法 对我院妇科2007年2月～2008年8月行腹腔镜治疗的855例病人的临床资料进行回顾性分析。结果 术后9例出现严重并发症, 并发症发生率为1.05%，其中术后腹腔内出血5例,膀胱损伤1例,输尿管损伤1例，腹壁穿刺孔出血2例。6例病人行二次手术，预后好。结论 妇科腹腔镜手术并发症的发生与手术的难度有关。提高医生的内镜手术技能和手术技巧,严格按规范操作,可降低妇科腹腔镜手术并发症的发生率。
【关键词】 妇科外科手术;腹腔镜检查;手术后并发症
AN OBSERVATION OF COMPLICATIONS OF LAPAROSCOPIC SURGERY IN GYNECOLOGY WANG FULING, WANG XIANGYU (Department of Gynecology, The Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, China); [ABSTRACT] Objective To analyze the causes of complications and discuss the prevention of laparoscopic surgery in gynecology. Methods The clinical data of 855 patients underwent laparoscopic operation in Department of Gynecology of our hospital from February 2007 to August 2008 were analyzed retrospectively. Results Nine patients had severe complications, with complication rate being 1.05%. In which, intraabdominal hemorrhage occurred in five cases, bladder injury in one, ureter injury in one and puncture site bleeding in two. Six patients underwent secondary surgery and recovered well. Conclusion The complications of laparoscopic surgery in gynecology are associated with the difficulties of the surgery. Improving the endoscopic skills of the doctor and strictly observing the standards of procedure can reduce the complications.
[KEY WORDS] Gynecologic surgical procedures; Laparoscopy; Postoperative complications
腹腔镜手术应用于妇科临床具有创伤小、病人痛苦少、恢复快等优势,随着手术适应证放宽,其并发症有逐渐增多的趋势。为及时认识、预防和正确处理这些并发症,以避免一些严重甚至危及病人生命的并发症的发生，本文对我院855例妇科腹腔镜手术病人的临床资料进行回顾性分析,现将结果报告如下。
1 资料与方法
1.1 一般资料
2007年2月～2008年8月,我院共施行妇科腹腔镜手术855例，病人年龄13～74岁,平均39.6岁。其中附件手术及子宫肌瘤挖出780例，盆腔炎性粘连30例，子宫全切或子宫加双附件切除45例。其中279例病人术前有盆腔手术史，包括子宫肌瘤挖出术、剖宫产术、阑尾切除术、卵巢肿瘤剥除术等。
1.2 手术方法
全部病人均采用经口气管插管静脉全身麻醉。腹腔镜辅助经阴子宫切除术及部分盆腔子宫内膜异位症病人术前考虑盆腔粘连严重者采取膀胱截石位,经阴道放置举宫器以操纵子宫;其余病人皆取平卧位。腹部穿孔3～4个，气腹压力为15 mmHg(1 mmHg=0
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