CAJ | 학술논문

目的：探讨腹腔镜技术在肥胖患者妇科急腹症治疗中的应用价值。方法回顾性分析409例妇科肥胖急腹症患者的临床资料，均因急腹症行腹腔镜诊疗，其中输卵管妊娠309例、卵巢妊娠8例、卵巢黄体破裂34例、卵巢巧克力囊肿破裂6例、卵巢囊肿蒂扭转29例、急性盆腔炎16例、子宫穿孔7例。结果409例患者腹腔镜手术均获成功，无中转开腹。行输卵管切除术254例；输卵管造口取胚术55例；卵巢内胚胎清除术8例；卵巢修补术34例；一侧附件切除术27例；卵巢囊肿剥除术2例；卵巢巧克力囊肿剥除术6例；急性盆腔炎炎性渗出液吸除或包裹性积液清除术16例；子宫修补术7例，其中腹腔节育器取出4例。术中并发症发生率为2．4％，术后近期并发症发生率为2．7％。结论对妇科肥胖患者急腹症，腹腔镜能及时正确诊断和治疗，具有创伤小、痛苦轻、恢复快、并发症少等优点，可治疗大部分妇科肥胖患者急腹症，具有良好的应用价值。
목적：탐토복강경기술재비반환자부과급복증치료중적응용개치。방법회고성분석409례부과비반급복증환자적림상자료，균인급복증행복강경진료，기중수란관임신309례、란소임신8례、란소황체파렬34례、란소교극력낭종파렬6례、란소낭종체뉴전29례、급성분강염16례、자궁천공7례。결과409례환자복강경수술균획성공，무중전개복。행수란관절제술254례；수란관조구취배술55례；란소내배태청제술8례；란소수보술34례；일측부건절제술27례；란소낭종박제술2례；란소교극력낭종박제술6례；급성분강염염성삼출액흡제혹포과성적액청제술16례；자궁수보술7례，기중복강절육기취출4례。술중병발증발생솔위2．4％，술후근기병발증발생솔위2．7％。결론대부과비반환자급복증，복강경능급시정학진단화치료，구유창상소、통고경、회복쾌、병발증소등우점，가치료대부분부과비반환자급복증，구유량호적응용개치。
Objective To investigate the clinical application value of laparoscopy in gynecologic acute abdomen in obese pa-tients.Methods To analyze retrospectively of clinical data of 409 patients diagnosed as gynecologic acute abdomen in obese women and treat with abdomen laparoscopic examination.The patients include 309 patients with tubal pregnancy;8 of ovarian pregnancy;34 of rupture of corpus luteum;6 of rupture of ovarian chocolate cyst;29 of torsion of ovarian cyst;16 of acute pelvic inflammatory disease;7 perforation of the uterus.Results 409 cases of patients with laparoscopic operation are successful which include 254 cases of tubal re-section;55 cases of tubal colostomy embryo;8 cases of ovary embryo removal;34 cases of ovary repair;27 cases of side accessory re-section;2 cases of enucleation of ovarion cyst;6 cases of enucleation of ovarian chocolate cyst;16 cases of acute pelvic inflammatory in-filtration of liquid suction or encapsulated effusion dissection;4 cases of peritoneal IUD removed,7 cases of uterine repair.Intraopera-tive complication rate is 2.4%,the rate of postoperative complications is 2.7%.Conclusion In the treatment of gynecological acute abdomen in obese patients, laparoscopy can not only timely and correct diagnose, and timely treat it, it also has the advantages in small trauma, mild pain, rapid recovery, less complications.It can replace the gynecological operation in the treatment of gynecologic acute abdomen in obese patients and has a good application prospect.