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目的评价分析盆腹腔手术史对妇科微创手术治疗效果的影响。方法选取2015年2月-2016年2月该院收治的妇科微创手术患者180例,其中既往有盆腹腔手术史者42例(观察组),既往无盆腹腔手术史者138例(对照组),回顾性分析患者的临床资料,讨论盆腹腔手术史对妇科微创手术治疗效果的影响。结果观察组患者盆腹腔粘连率(52.38%)高于对照组(9.42%),差异有统计学意义(P<0.05);两组患者盆腹腔粘连程度及手术指标比较,差异无统计学意义(P>0.05);妇科、产科、外科、混合等不同手术原因粘连发生率及粘连程度比较,差异有统计学意义(P<0.05);两组手术指标比较,差异无统计学意义(P>0.05);微创手术粘连率较开腹手术更低(P<0.05);两组患者粘连程度、手术指标比较,差异无统计学意义(P>0.05);既往仅1次盆腹腔手术史患者粘连率低于多次手术史者,粘连程度、手术指标比较,差异有统计学意义(P<0.05)。结论既往有盆腹腔手术史患者可安全实施妇科微创手术,但术前应仔细检查,预判粘连部位,选择合适的穿刺位置,熟练掌握手术操作技巧,减少手术损伤和风险,提高治疗效果。
Objective To evaluate the influence of the history of pelvic and abdominal surgery on the effect of minimally invasive surgery in gynecology. Methods 180 cases of gynecological minimally invasive surgery admitted from February 2015 to February 2016 in our hospital were selected. Among them, there were 42 cases with past history of pelvic and abdominal surgery (observation group), 138 cases without history of pelvic and abdominal surgery ), Retrospectively analyzed the clinical data of patients to discuss the effect of pelvic surgery on the effect of minimally invasive surgery. Results The rate of pelvic adhesions in observation group was higher than that in control group (52.38%), the difference was statistically significant (P <0.05). There was no significant difference between the two groups in the degree of pelvic adhesions and surgical indexes P> 0.05). The incidence of adhesions and the degree of adhesion in gynecological, obstetric, surgical and mixed surgical operations were significantly different (P <0.05). There was no significant difference in operative indexes between the two groups (P> 0.05 ). The adhesion rate of minimally invasive surgery was lower than that of laparotomy (P <0.05). There was no significant difference in the degree of adhesion between the two groups of patients and the operation indexes (P> 0.05) Rate lower than multiple surgical history, adhesion, surgical indicators, the difference was statistically significant (P <0.05). Conclusion In the past, pelvic surgery patients with history of minimally invasive gynecological surgery may be safe, but should be carefully examined preoperatively, predict the site of adhesion, select the appropriate puncture position, proficiency in surgical techniques to reduce the surgical injury and risk and improve the therapeutic effect.