腹腔镜下子宫切除术中出血的防治  

The Control of Hemorrhage in Hysterectomy under Laparoscopic

作　　者：乔雅威 孙国玉 王刚[2] 张宓 甘淑君 吕陈梅 陈露诗[2] 李光仪[2] 梁栋[2] 黄淑瑜[2] 陈云卿[2] 

机构地区：[1]赤峰市元宝山区妇幼保健所,内蒙古赤峰024076 [2]中山大学附属佛山第一医院 [3]赤峰宝山医院

出　　处：《中外医学研究》2014年第14期120-121,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:通过对617例腹腔镜下子宫切除术的临床分析,进一步了解术中出血的原因及防治措施。方法:采用回顾性总结的方法,重点总结术式、手术时间、术中出血原因及防治措施。结果:平均住院时间(5.27±1.13)d,平均手术时间(68.43±21.24)min,平均出血量(37.22±14.00)ml。2例子宫动静脉出血者应用钛夹止血。附件区出血者8例应用钛夹止血,9例双极电凝止血,5例单极电凝止血。结论:腹腔镜下子宫切除术中出血钛夹止血准确无误,再结合双极电凝及单极电凝止血。发生出血时止血效果好、对组织损伤小的是双极电凝,Ligasure因为头太大反而不好使用,单极电凝止血效果也很好,但易损伤周围组织。超声刀在发生止血时效果最差。Objective：To further understand the reasons and prevention of bleeding through clinical analysis of laparoscopic hysterectomy in 617 cases. Method：Using retrospective approach,summarize the operation type,operation time,bleeding in operation causes and prevention measures. Result：The average hospital stay were （5.27±1.13）days,the average operation time were （68.43±21.24）min,the average bleeding volume were （37.22±14.00）ml. Two cases of uterine arteriovenous hemorrhage using titanium clip hemostasis. Eight cases of the attachment area hemorrhage were used titanium clip hemostasis,9 cases were given bipolar coagulation hemostasis,5 patients were given unipolar electrocoagulation. Conclusion：Laparoscopic hysterectomy bleeding,titanium clip hemostasis is accurate,combined with bipolar coagulation and unipolar electrocoagulation. Hemorrhage,good hemostatic effect on tissue damage and small is bipolar coagulation. Ligasure is too large but not good use because of the head,the monopolar electrocoagulation hemostasis is also very good,but easy to damage the surrounding tissue. The hemostatic effect of ultrasonic knife occurred in the worst.

关 键 词：腹腔镜 子宫切除术 出血 

分 类 号：R713.4[医药卫生—妇产科学]