妇科腹腔镜手术中腹腔脏器和血管损伤14例原因分析  

Cause Analysis of 14 Cases of Organ and Vascular Injuries in Laparoscopic Surgery

作　　者：徐晓英[1] 龙雯晴 薛晓玲[1] 

机构地区：[1]南通大学附属海安医院妇产科,江苏南通226600 [2]瑞金医院妇产科,上海310000

出　　处：《临床误诊误治》2016年第2期64-67,共4页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨妇科腹腔镜手术中并发症发生的原因、预防及处理措施。方法回顾性分析2010年1月—2014年12月南通大学附属海安医院和上海瑞金医院妇产科施行妇科腹腔镜手术中发生腹腔脏器和血管损伤14例的临床资料。结果本组发生腹腔脏器和血管损伤14例,术中并发症发生率0.36%,其中进行子宫切除手术者并发症发生率最高,其次为进行附件手术者。血管损伤10例,其中腹壁血管损伤6例,腹腔内出血4例;脏器损伤4例,其中膀胱损伤2例,肠管损伤和输尿管损伤各1例。14例均经及时妥善处理后恢复良好。结论妇科腹腔镜术中并发症发生率与手术难度和术者经验有关;加强基本功训练,掌握好手术适应证,术中认真、谨慎操作,可减少其并发症发生率;及时发现和妥善处理相关并发症,一般预后较佳。Objective To investigate the causes,the prevention and treatment measures of complication from the laparoscopic surgery. Methods A retrospective analysis of clinical data of 14 cases of organ and vascular injuries in laparoscopic surgery during January 2010 and December 2014 was made in department of obstetrics and gynecology of Haian Hospital affiliated of Nantong and Shanghai Ruijin Hospital. Results There were 14 cases of abdominal organ and vascular injuries,and complication rate was 0. 36%,with hysterectomy complications being the highest incidence rate,and followed by attachment surgery. There were 10 cases of vascular injury,including 6 cases of abdominal vascular injury,4 cases of mesenteric vascular; 4 cases of organ injury,including 2 cases of bladder injury,1 case of bowel injury and ureteral injury. All the patients recovered well after timely treatment. Conclusion Laparoscopic surgery and vascular damage complications are correlated with difficulty of the operation and experience of the surgeon. Good surgical indications,strengthening the basic training,mastery of the complications during the operations are essential to reduce the incidence of complications. Careful observation and quick and proper management of relating complications are of help for good prognosis.

关 键 词：腹腔镜检查 妇科外科手术 并发症 血管系统损伤 脏器损伤 

分 类 号：R713[医药卫生—妇产科学]