脐孔Trocar穿刺法在妇科腹腔镜穿刺失败肥胖患者的应用  

Application of intraumbilical Trocar puncture in obese patients with failed gynecological laparoscopic puncture

作　　者：吴春林[1] 王中显 龚世雄[1] Wu Chunlin;Wang Zhongxian;Gong Shixong(Department of Obstetrics and Gynecology,Wuhan No.1 Hospital,Wuhan Hubei 430022,P.R.China)

机构地区：[1]武汉市第一医院妇产科,湖北武汉430022

出　　处：《中国计划生育和妇产科》2022年第11期83-86,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的 明确脐孔Trocar穿刺法在妇科常规腹腔镜穿刺失败肥胖患者应用的可行性。方法 收集2018年1月至2021年1月在武汉市第一医院因常规腹腔镜穿刺失败行脐孔Trocar穿刺的25例肥胖患者的临床资料,对患者体质量指数、穿刺成功率、穿刺时间、穿刺术中的并发症及术后1月、3月、6月随访发现的穿刺相关并发症进行统计学分析。结果 常规腹腔镜穿刺失败行脐孔Trocar穿刺的25例肥胖患者平均体质量指数(35.61±3.19)kg/m^(2),穿刺成功率为100%,穿刺平均时间(4.22±0.67)min,穿刺过程中无肠管、血管损伤及皮下气肿、血肿等并发症发生,患者术后1月、3月、6月无脐部感染、肉芽肿及脐疝等并发症发生。结论 初步证实脐孔Trocar穿刺法在妇科常规腹腔镜穿刺失败肥胖患者的应用安全可行,需多中心大样本量研究进一步证实其临床安全性及有效性。Objective To clarify the feasibility of the application of intraumbilical trocar puncture in obese patients with failed routine laparoscopic puncture in gynecology.Methods The clinical data of 25 obese patients who underwent intraumbilical Trocar puncture due to the failure of conventional laparoscopic puncture in Wuhan No.1 Hospital from January 2018 to January 2021 were collected.The patients’ body mass index, puncture success rate, puncture time, intraoperative complications and 1 month, 3 months, 6 months postoperative complications related to intraumbilical trocar puncture were statistically analyzed.Results The 25 obese patients who failed conventional laparoscopic puncture and performed intraumbilical trocar puncture had an average body mass index of(35.61±3.19)kg/m^(2),a puncture success rate of 100%,and an average puncture time of(4.22±0.67) minutes.No intestinal, vascular injury and subcutaneous emphysema, subcutaneous hematoma occurred during the intraumbilical trocar.Followed-up at 1 month, 3 months, and 6 months after surgery, no complications such as umbilical infection, granuloma and umbilical hernia occurred.Conclusion It was preliminarily confirmed that the umbilical Trocar puncture method is safe and feasible in obese patients with failed routine laparoscopic puncture in gynecology, and multi-center large sample size study is needed to further confirm its clinical safety and effectiveness.

关 键 词：脐孔Trocar穿刺法 腹腔镜 穿刺失败 肥胖 应用 

分 类 号：R713.1[医药卫生—妇产科学]