自制纱布卷压迫止血法在妇科腹腔镜术中渗血的应用研究  

Application of self-made gauze for compression hemostasis in gynecological laparoscopic surgery

作　　者：张书敏[1] 薛白[1] 胡军武[1] 方月兰[1] 

机构地区：[1]南京鼓楼医院集团宿迁市人民医院妇产科,江苏宿迁223800

出　　处：《中国计划生育和妇产科》2017年第12期21-24,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：2017年江苏省宿迁市市级指导性科技计划项目(项目编号:Z201716)

摘　　要：目的探讨自制纱布卷压迫止血法在处理妇科腹腔镜术中渗血的临床应用。方法回顾性分析2012年1月至2016年8月于南京鼓楼医院集团宿迁市人民医院因子宫肌瘤、子宫内膜异位症、盆腔包裹性囊肿等行腹腔镜手术治疗的291例患者的临床资料,其中采用盆腔纱布压迫止血方法处理创面渗血的145例患者为研究组,使用电凝止血、止血纱等传统方法处理腹腔镜手术创面渗血的146例患者为对照组,比较两组患者的手术时间、术中出血量、术后体温、术后抗生素使用时间、术后感染和术后损伤的发生率。结果研究组的手术时间和术中出血量均少于对照组,差异有统计学意义(P<0.05);两组术后发热>3 d的发生率差异无统计学意义(P>0.05);研究组无术后感染及术中损伤病例,对照组术后发生输尿管瘘1例和可疑损伤2例。结论自制纱布卷盆腔压迫止血法在妇科腹腔镜术中处理创面渗血安全、有效,方法简便易得,值得推广。Objective To investigate the application of self - made gauze for compression hemostasis in gynecological laparoscopic surgery. Methods Clinical data of 291 patients who underwent laparoscopic surgery in Suqian People＇s Hospital due to uterine fibroids, endometriosis, pelvic encapsulated cysts and other diseases from January 2012 to August 2016 were analyzed retrospectively. 145 patients with wound bleeding treated by pelvic gauze hemostasis were selected as the study group, other 146 patients treated with traditional methods such as electrocoagulation hemostasis and hemostatic yarn were selected as the control group. The operative time, intraoperative blood loss, postoperative body temperature, postoperative antibiotic use time, postoperative infection and postoperative injury were compared between the two groups. Results The operative time and intraoperative blood loss were lower in the study group than in the control group, the differences were statistically significant （ P 〈 0. 05 ）. The incidence of postoperative fever more than 3 d was not increased in the study group（P 〉0. 05）. There was no postoperative infection and intraoperative injury in the study group. The control group had 1 case of ureteral fistula and 2 cases of suspicious injury. Conclusion The application of self - made gauze for compression hemostasis in gynecological laparoscopie surgery is safe and effective, simple and easy to obtain, thus worthy of promotion.

关 键 词：腹腔镜手术 纱布卷 压迫止血 

分 类 号：R713[医药卫生—妇产科学]