天津医药
天津醫藥
천진의약
Tianjin Medical Journal
2015年
10期
1190-1193
,共4页
王海芳%李强%张爱华%姚爱琳
王海芳%李彊%張愛華%姚愛琳
왕해방%리강%장애화%요애림
腹腔镜%外科手术,计算机辅助%子宫切除术%并发症%肌瘤切除术
腹腔鏡%外科手術,計算機輔助%子宮切除術%併髮癥%肌瘤切除術
복강경%외과수술,계산궤보조%자궁절제술%병발증%기류절제술
laparoscopy%surgery,computer-assisted%hysterectomy%concurrent disease%muscular tumor excision
目的：探讨腹腔镜下子宫手术并发症发生的影响因素及预防措施。方法行腹腔镜子宫手术患者415例，分为子宫切除组310例和肌瘤切除组105例，比较2组术中及术后胃肠损伤、泌尿损伤及出血等并发症发生率。将415例患者按子宫大小分为子宫体积≤300 cm3（A组），300 cm3<子宫体积<600 cm3（B组）,子宫体积≥600 cm3（C组）。分析子宫大小、盆腔粘连与并发症发生的关系。结果共23例（5.54%）发生并发症，其中子宫切除组4.51%（14/310），肌瘤切除组8.57%（9/105），差异无统计学意义（P>0.05）。术中或术后出血发生率为1.93%（8/415）,胃肠损伤及泌尿损伤发生率均为0.96%(8/415)。并发症的发生率C组20.0%（8/40）高于A组2.8%（5/179）及B组5.1%（10/196，均P<0.01），A、B组差异无统计学意义（P>0.05）。盆腔粘连组发生率高于无盆腔粘连组[8.3%（15/180）vs 3.4%（8/235），P<0.05]。结论腹腔镜子宫手术并发症发生与患者的选择、术者的经验有关，无盆腔粘连且子宫体积<600 cm3患者最适合行腹腔镜手术。
目的：探討腹腔鏡下子宮手術併髮癥髮生的影響因素及預防措施。方法行腹腔鏡子宮手術患者415例，分為子宮切除組310例和肌瘤切除組105例，比較2組術中及術後胃腸損傷、泌尿損傷及齣血等併髮癥髮生率。將415例患者按子宮大小分為子宮體積≤300 cm3（A組），300 cm3<子宮體積<600 cm3（B組）,子宮體積≥600 cm3（C組）。分析子宮大小、盆腔粘連與併髮癥髮生的關繫。結果共23例（5.54%）髮生併髮癥，其中子宮切除組4.51%（14/310），肌瘤切除組8.57%（9/105），差異無統計學意義（P>0.05）。術中或術後齣血髮生率為1.93%（8/415）,胃腸損傷及泌尿損傷髮生率均為0.96%(8/415)。併髮癥的髮生率C組20.0%（8/40）高于A組2.8%（5/179）及B組5.1%（10/196，均P<0.01），A、B組差異無統計學意義（P>0.05）。盆腔粘連組髮生率高于無盆腔粘連組[8.3%（15/180）vs 3.4%（8/235），P<0.05]。結論腹腔鏡子宮手術併髮癥髮生與患者的選擇、術者的經驗有關，無盆腔粘連且子宮體積<600 cm3患者最適閤行腹腔鏡手術。
목적：탐토복강경하자궁수술병발증발생적영향인소급예방조시。방법행복강경자궁수술환자415례，분위자궁절제조310례화기류절제조105례，비교2조술중급술후위장손상、비뇨손상급출혈등병발증발생솔。장415례환자안자궁대소분위자궁체적≤300 cm3（A조），300 cm3<자궁체적<600 cm3（B조）,자궁체적≥600 cm3（C조）。분석자궁대소、분강점련여병발증발생적관계。결과공23례（5.54%）발생병발증，기중자궁절제조4.51%（14/310），기류절제조8.57%（9/105），차이무통계학의의（P>0.05）。술중혹술후출혈발생솔위1.93%（8/415）,위장손상급비뇨손상발생솔균위0.96%(8/415)。병발증적발생솔C조20.0%（8/40）고우A조2.8%（5/179）급B조5.1%（10/196，균P<0.01），A、B조차이무통계학의의（P>0.05）。분강점련조발생솔고우무분강점련조[8.3%（15/180）vs 3.4%（8/235），P<0.05]。결론복강경자궁수술병발증발생여환자적선택、술자적경험유관，무분강점련차자궁체적<600 cm3환자최괄합행복강경수술。
Objective To study the influence factors and prevention measures of complication of laparoscopic uter?ine surgery. Methods Patient who underwent laparoscopic uterine surgery were collected (n=415) and divided into hyster?ectomy group (n=310) and myomectomy group (n=105). Intraoperative and postoperative complications such as gastrointesti?nal injury, urinary injury and bleeding were recorded and compared between these two groups. Base on their uterine size, pa?tients were divided into Group A (uterine volume ≤300 cm3), Group B (300 cm3 <uterine volume <600 cm3) and Group C (uterine volume ≥ 600 cm3). Correlation between uterine size or pelvic adhesions with complications are investigated. Re?sults A total of 23 patients (5.54%) were with complications. Complication occurrence in hysterectomy group was 4.51%(14/310) and in myomectomy group was 8.57%(9/105) . The difference was not statistically significant (P>0.05). The inci?dence of intraoperative or postoperative bleeding was 1.93%(8/415) and incidence of gastrointestinal damage or urinary inju?ry rate was 0.96%(8/415). The incidence of complications in group C was 20.0%(8/40) which is higher than that in group A (2.8%;5/179) and group B (5.1%;10/196). P<0.01 in all cases. The difference between group A and group B was not signif?icant (P>0.05). The incidence in pelvic adhesions group is higher than that in the group without pelvic adhesions [8.3%(15/180) vs 3.4%(8/235), P<0.05]. Conclusion The incidence of complications in laparoscopic myomectomy was higher than that in laparoscopic hysterectomy. When patients were without pelvic adhesions or with uterine volume< 600 cm3, laparo?scopic surgery present least complication.
