对导致腹腔镜手术后穿刺孔出血原因的分析  

The Reason of Bleeding from the Puncture Hole after Laparoscopic Operation

作　　者：方向[1] 麦刚[1] 刘忠亮[1] 刘力笼 安亮[1] 张跃天[1] 

机构地区：[1]德阳市人民医院普外科,四川德阳618000

出　　处：《当代医药论丛》2017年第15期122-123,共2页

基　　金：四川省医学科研课题;编号:S15030

摘　　要：目的 :探讨导致腹腔镜手术后穿刺孔出血的原因。方法 :选取近几年在德阳市人民医院进行腹腔镜手术的4356例患者作为研究对象。这些患者均使用传统方法缝合穿刺孔。统计这些患者发生穿刺孔出血的几率。分析导致这些患者发生穿刺孔出血的原因。结果 :这些患者发生术后穿刺孔出血的几率为0.62%(27/4356)。27例穿刺孔出血患者发生穿刺孔出血的原因主要是:肌肉层未缝合、肌肉层未完全缝合、缝合线打结不紧、扩张穿刺孔致腹膜血管损伤、麻醉苏醒致腹壁紧张、盲目多点穿刺致腹壁肌肉损伤、门静脉高压及术中止血不彻底。结论 :导致腹腔镜手术后穿刺孔出血的主要原因有穿刺孔缝合不到位、缝合线打结不紧及术中止血不彻底等。Objective To analyse the reason of bleeding from the puncture hole after laparoscopic operation. Methods Select 4356 cases of puncture bleeding patients after laparoscopic operation in People＇s Hospital of Deyang City for research object.After operation,we sew puncture holes of these patients by routine method.Caculate incidence of puncture bleeding among these patients and analyse reasons of bleeding.Incidence of puncture bleeding is 0.62%（27/4356）. Results The reasons of puncture bleeding are masule layer unstitched or not stitched completely, stitches are not tight, peritoneal vascular injury caused by expanding puncture hole, abdominal wall resistance by anesthesia recovery, abdominal muscle injury by blind multipoint puncture, portal hypertension and uncovered hemostasis in operation. Conclusion The reason of bleeding from the puncture hole after laparoscopic operation are pucture hole were not stitched completely, stitches are not tight and uncovered hemostasis in operation etc.

关 键 词：腹腔镜手术 穿刺孔 出血 缝合 打结 

分 类 号：R656[医药卫生—外科学]