冠状动脉支架术后行腹腔镜妇科手术33例临床总结  

Clinical summary of 33 patients undergoing gynecological laparoscopic operation after coronary artery stent

作　　者：范颖[1] 张军[1] 王皓洁[1] 李斌[1] 

机构地区：[1]首都医科大学附属北京安贞医院,100029

出　　处：《中国妇产科临床杂志》2015年第3期218-220,共3页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨冠心病患者在冠状动脉支架术后行腹腔镜妇科手术（Laparoscopic gynecologic surgery,Lgs）的可行性、安全性。方法 2008年10月至2014年1月,33例冠状动脉支架植入术后患者行妇科腹腔镜手术,术中采取低流量（〈2L/min）、低压腹腔镜手术19例、无气腹腹腔镜14例。围术期29例采用肝素替代阿司匹林,4例未停用阿司匹林。结果33例患者均顺利完成手术,手术时间30~90 min,术中出血量30~150ml,无中转开腹。住院时间4~7d。术中、术后无副损伤、感染发生,术后未出现血栓形成、冠状动脉再狭窄病例。术后随访6个月,8例因妇科手术去除贫血病因后心功能由Ⅱ级改善为Ⅰ级,1例出现支架内再狭窄。结论因妇科疾病需要手术治疗的冠状动脉支架植入的患者经充分术前评估、恰当围术期处理,是能够耐受腹腔镜手术的。Objective To discuss the feasibility and safety of laparoscopic gynecologic surgery （LGS） on pa- tients suffering from gynecological diseases after coronary in--sent operation. Methods From October 2008 to Jan- uary 2014, 33 patients with gynecological diseases after coronary in--sent operation underwent laparoscopic gyneco- logic surgery. LGS was performed on 19 patients with low flow （〈2 L/min） and low pressure. Gasless laparosco- py was peformed on 14 patients. 29 patiens received heparin instead of Aspirin pre-and postoperation. 4 patients did＇t stop using anti-platelet medicine. Results The operation time was 30 to 90 min. The intraoperative blood loss was 30 to 150 ml. The length of stay was 4 to 7 days. There was no side injury and infection during operation and no thrombosis and coronary restenosis postoperative. The patients were followed up for 6 months, heart function improved in 8 cases from NYHA II to I due to the improving of anemia, 1 coronary restenosis occured. Conclusion For patients suffering from gynecological diseases after coronary in-- stent operation, LGS is feasible and safety a{ter adequate preoperative evaluatiort and appropriate perioperative care.

关 键 词：冠状动脉支架术后 妇科 腹腔镜手术 

分 类 号：R541.4[医药卫生—心血管疾病]