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目的 探讨超声手术刀在妇科腹腔镜手术中的应用价值。方法 在腹腔镜下应用超声手术刀进行各种妇科手术 ,观察术中失血量、手术时间、围手术期体温和血象变化以及组织的损伤程度。结果 在腹腔镜下使用超声手术刀进行各种手术 4 2例。其中子宫切除术 4例 ,卵巢囊肿剥出或切除术 9例 ,输卵管切除术 18例 ,输卵管切开取胚术 4例 ,子宫肌瘤挖出术 3例 ,单纯粘连分离术 3例 ,附件切除术 1例。术中失血量、手术时间以及对组织的损伤程度与手术类型有关 ,最少失血量、手术时间、组织的损伤深度、损伤评分以及纤维蛋白沉积评分平均分别为 2 4 77± 4 71毫升、2 3 39± 3 0 1分钟、0 2 2± 0 10毫米、0 98± 0 2 1和 0 38±0 2 6 ,最大失血量、手术时间、组织的损伤深度、损伤评分以及纤维蛋白沉积评分平均分别为 16 6 7± 4 7 18毫升、12 7 2± 16 99分钟、0 35± 0 2 0毫米、1 2 5± 0 2 0和 0 81± 0 2 9。除子宫切除术以外 ,其它各种手术在手术前后体温、血红蛋白以及白细胞总数之比较差异无显著性。结论 超声手术刀在妇科腹腔镜下进行各种妇科手术 ,由于操作简单 ,安全可靠的 ,因而值得推广。
Objective To explore the value of ultrasonic scalpel in gynecological laparoscopic surgery. Methods The laparoscopic ultrasonic scalpel for gynecological surgery was performed. The intraoperative blood loss, operation time, perioperative temperature and blood changes, and the degree of tissue damage were observed. Results In laparoscopic operation with scalpel 42 cases of various surgical procedures. Including hysterectomy in 4 cases, ovarian cyst stripping or resection in 9 cases, tubal resection in 18 cases, tubal embryo embedding in 4 cases, uterine fibroids in 3 cases, simple adhesions in 3 cases, attachment resection Surgery in 1 case. Intraoperative blood loss, operation time and degree of tissue damage were related to the type of surgery. The minimum blood loss, operation time, tissue depth of injury, injury score and fibrin deposition score were 2477 ± 4 71 ml and 23 39 ± 3 0 1 minutes, 0 2 2 ± 0 10 mm, 0 98 ± 0 2 1 and 0 38 ± 0 2 6, respectively. The maximum blood loss, operation time, depth of injury, damage score and fibrin deposition score were respectively 16 6 7 ± 4 7 18 ml, 12 72 ± 16 99 minutes, 0 35 ± 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 In addition to hysterectomy, other various surgical preoperative and postoperative body temperature, hemoglobin and leukocytes in total no significant difference. Conclusion Ultrasonic scalpel in gynecological laparoscopic gynecological surgery, due to simple, safe and reliable, and therefore worth promoting.