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目的:探讨引起妇科腹腔镜手术并发症的相关因素和防治方法。方法:对广东省河源市妇幼保健院2009年9月~2011年3月就诊的488例妇科腹腔镜手术患者的临床资料进行回顾性分析。结果:488例腹腔镜手术患者中,发生各种并发症12例,发生率为2.46%,其中持续性异位妊娠1例,腹膜外气肿5例,膀胱损伤1例,肠管损伤1例,血管损伤4例。2例需中转开腹手术,占0.41%,1例为肠管损伤,1例为血管损伤。持续性异位妊娠给予MTX和米非司酮治疗;并发腹膜外气肿患者均未给予特殊处理;膀胱损伤患者术后留置导尿管引流,自行愈合;肠管损伤患者行肠切除修补术;对血管损伤患者行保守抗感染治疗,术后血肿缓慢自行吸收。结论:妇科腹腔镜手术并发症与手术难度、术者技巧及熟练程度有关,正确掌握手术指征,严格按规范操作,积极预防可降低并发症的发生率。
Objective: To investigate the related factors of gynecological laparoscopic surgery complications and prevention methods. Methods: The clinical data of 488 gynecological laparoscopic patients from September 2009 to March 2011 in Heyuan MCH hospital of Guangdong Province were retrospectively analyzed. Results: 488 cases of complications occurred in 12 cases, the incidence was 2.46%, of which 1 case of persistent ectopic pregnancy, extraperitoneal emphysema in 5 cases, 1 case of bladder injury, bowel injury in 1 case, 4 cases of vascular injury. Necrosis was required in 2 cases, accounting for 0.41%. One case was bowel injury and one case was vascular injury. Continuous ectopic pregnancy given MTX and mifepristone treatment; complicated with extraperitoneal emphysema patients were not given special treatment; bladder injury indwelling catheter drainage, self-healing; bowel injury patients underwent enteral resection repair; Patients with vascular injury conservative anti-infective treatment, postoperative hematoma slowly self-absorption. Conclusions: The complications of gynecological laparoscopic surgery are related to the difficulty of operation, skills and proficiency of the surgeon, correctly grasp the operation indications, operate strictly in accordance with norms, and actively prevent it from reducing the incidence of complications.