妇科腹腔镜手术2700例临床分析  

Clinical analysis of laparoscopic procedure in treatment of 2700 cases with gynecologic diseases

作　　者：程忠平[1] 胡丽萍[1] 帅桂珍[1] 季芳[1] 瞿晓燕[1] 康乐[1] 龚军[1] 

机构地区：[1]上海市杨浦区中心医院妇产科,200090

出　　处：《上海医学》2005年第3期182-186,共5页Shanghai Medical Journal

摘　　要：目的　探讨妇科腹腔镜的手术方式、手术适应证及其并发症。方法　回顾分析我院近5 年2700例妇科腹腔镜手术患者的临床资料。结果　手术适应证主要为子宫肌瘤、卵巢囊肿、子宫内膜异位症及异位妊娠,占91.8%(2478/2700例)。手术方式主要为筋膜内子宫切除术、腹腔镜辅助阴道子宫切除术、子宫肌瘤剜出术、卵巢囊肿剥出术及异位妊娠手术,占93.1%(2514/2700例)。腹腔镜手术占同期妇科手术的64.9%,急腹症腹腔镜实施率达63.3%。腹腔镜手术并发症发生率为1.6%(43/2700例)。结论　腹腔镜技术的进步拓宽了手术指征,降低了手术并发症的发生率。只要合理把握手术适应证,腹腔镜技术可替代妇科大部分腹式手术。Objective To appraise the operative technique, indications and complications of gynecologic laparoscopy.Methods To analyze retrospectively the clinical data of 2700 cases with gynecologic diseases who underwent laparoscopic procedure during the period of 2000.1～2004.12.Results In this period, nearly 64.9% patients were undertaken laparoscopy in our center. The major indications for laparoscopic procedure were uterine fibroids,ovarian cyst, endometriosis and ectopic pregnancy, occupying 91.8% of all patients. The major operative modalities included CISH, LAVH, myomectomy and various stages of ectopic pregnancy, accounting for 93.1% of total laparoscopies. Laparoscopic procedure was accounted as 64.9% for all gynecologic surgery in the same period and as 63.3% for acute abdominal emergency. Complications occurred in 43 cases(1.6%). Conclusion With advancement of laparoscopic techniques, the laparoscopic operative indications could be widened with decrease of complications. With proper selection of indication, many gynecologic abdominal surgery may be replaced by laparoscopic procedure.

关 键 词：妇科腹腔镜手术 临床分析 腹腔镜辅助阴道子宫切除术 筋膜内子宫切除术 手术适应证 子宫内膜异位症 子宫肌瘤剜出术 腹腔镜技术 并发症发生率 手术方式 异位妊娠 囊肿剥出术 手术并发症 临床资料 手术患者 回顾分析 卵巢囊肿 

分 类 号：R713[医药卫生—妇产科学] R713.4[医药卫生—临床医学]