中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2013年
5期
386-388
,共3页
王刚成%韩广森%任莹坤%刘英俊%程勇%张健%赵玉洲%徐勇超%鲁朝敏
王剛成%韓廣森%任瑩坤%劉英俊%程勇%張健%趙玉洲%徐勇超%魯朝敏
왕강성%한엄삼%임형곤%류영준%정용%장건%조옥주%서용초%로조민
止血,手术%缝合技术%骶前静脉丛出血%带蒂大网膜
止血,手術%縫閤技術%骶前靜脈叢齣血%帶蒂大網膜
지혈,수술%봉합기술%저전정맥총출혈%대체대망막
Hemostasis,surgical%Suture techniques%Presacral venous plexus hemorrhage%Pedicled omentum
目的 探讨联合带蒂大网膜集束式缝合技术对骶前静脉丛出血的止血效果.方法 回顾性分析12例骶前术操作过程中骶前出血患者的临床资料,其中男8例,女4例,年龄45～82岁,中位年龄(68±11)岁.12例患者中,6例为直肠癌；2例为骶前畸胎瘤；3例为子宫肉瘤术后复发；1例盆腔恶性神经鞘瘤.12例患者均采用联合带蒂大网膜集束式缝合控制骶前出血的方法进行缝合止血,观察12例患者利用该方法处理过程中骶前静脉的出血量及所需要的处理时间.结果 12例患者中,11例利用联合带蒂大网膜集束式缝合技术止血效果满意,缝合完成至术后1周未再出血,1例止血效果差,行经尾骨骶前辅助切口棉垫压迫方法进行止血.11例患者中位止血时间15 min,中位出血量150ml.结论 联合带蒂大网膜集束式缝合技术是处理骶前静脉丛出血有效方法之一,适合于单纯缝合止血效果差、不接受骶前棉垫填塞止血的患者.
目的 探討聯閤帶蒂大網膜集束式縫閤技術對骶前靜脈叢齣血的止血效果.方法 迴顧性分析12例骶前術操作過程中骶前齣血患者的臨床資料,其中男8例,女4例,年齡45～82歲,中位年齡(68±11)歲.12例患者中,6例為直腸癌；2例為骶前畸胎瘤；3例為子宮肉瘤術後複髮；1例盆腔噁性神經鞘瘤.12例患者均採用聯閤帶蒂大網膜集束式縫閤控製骶前齣血的方法進行縫閤止血,觀察12例患者利用該方法處理過程中骶前靜脈的齣血量及所需要的處理時間.結果 12例患者中,11例利用聯閤帶蒂大網膜集束式縫閤技術止血效果滿意,縫閤完成至術後1週未再齣血,1例止血效果差,行經尾骨骶前輔助切口棉墊壓迫方法進行止血.11例患者中位止血時間15 min,中位齣血量150ml.結論 聯閤帶蒂大網膜集束式縫閤技術是處理骶前靜脈叢齣血有效方法之一,適閤于單純縫閤止血效果差、不接受骶前棉墊填塞止血的患者.
목적 탐토연합대체대망막집속식봉합기술대저전정맥총출혈적지혈효과.방법 회고성분석12례저전술조작과정중저전출혈환자적림상자료,기중남8례,녀4례,년령45～82세,중위년령(68±11)세.12례환자중,6례위직장암；2례위저전기태류；3례위자궁육류술후복발；1례분강악성신경초류.12례환자균채용연합대체대망막집속식봉합공제저전출혈적방법진행봉합지혈,관찰12례환자이용해방법처리과정중저전정맥적출혈량급소수요적처리시간.결과 12례환자중,11례이용연합대체대망막집속식봉합기술지혈효과만의,봉합완성지술후1주미재출혈,1례지혈효과차,행경미골저전보조절구면점압박방법진행지혈.11례환자중위지혈시간15 min,중위출혈량150ml.결론 연합대체대망막집속식봉합기술시처리저전정맥총출혈유효방법지일,괄합우단순봉합지혈효과차、불접수저전면점전새지혈적환자.
Objective To evaluate the effect of cluster ligature combined with pedicled omentum coverage in controlling presacral venous plexus hemorrhage during pelvic surgery.Methods A total of 12 patients [8 males and 4 females,median age of (68-± 11) years] with presacral venous plexus hemorrhage were treated using cluster ligation combined with pedicled omentum coverage.Pelvic surgery included rectal cancer in 6 cases,recurrent uterine sarcoma in 3,pelvic teratoma in 2,malignant neurinoma in 1,respectively.Results Of the 12 patients complicated with massive intraoperative bleeding,11 were successfully treated.The patient in whom the procedure failed received subsequent pad packing with an arcshaped transperineal incision in front of the apex of coccyx.There was no patient suffered from postoperative hemorrhage.Conclusions For massive presacral venous plexus hemorrhage,cluster ligation combined with pedicled greater omentum coverage is effective.
