妇科腹腔镜手术170例分析_临床医学论文.docVIP

妇科腹腔镜手术170例分析_临床医学论文 妇科腹腔镜手术170例分析_临床医学论文 【关键词】 ,,腹腔镜 摘要：目的:探讨妇科腹腔镜手术的临床应用价值。方法:170例腹腔镜手术病例均采用全麻，主要器械为单极双极电凝，异位妊娠术式为输卵管切开取胚术、输卵管切除术;卵巢囊肿手术采用囊肿剥除术及卵巢成形术、患侧附件切除术;子宫手术采用肌瘤剥除术、改良CISH术、子宫次全切除术、子宫全切术及LAVH术。结果:腹腔镜手术占同期妇科手术的45.09%，手术成功率98.8%,中转开腹率1.2%，并发症发生率2.9%,包括皮下气肿2例,皮下血肿1例,脐部切口裂开1例,盆腔血肿1例。结论:掌握好适应证,妇科大部分手术可在腹腔镜下完成。 　　关键词： 妇科手术； 腹腔镜 　　Analysis of 170 cases of Laparoscopic Surgery in the Treatment of Gynecologic Diseases 　　Abstract： Objective: To explore the value of laparoscopic operation in the treatment of gynecologic diseases. Methods:170 patients with benign gynecologic diseases were successfully managed by laparoscope without major intraoperative or postoperative complications.All of these operations were performed with monopolar and bipolar electrosurgery，Patients with ectopic pregnancy underwent laparoscopic salpingotomy, salpingectomy or embryo removed from fimbria. For ovarian cyst, oophorocystectomy adnexectomy and ovary forming technique were performed. Improved LM(laparoscopic myomectomy) CISH, LSH(laparoscopic supracervical hysterectomy), LTH(laparoscopic total hysterecotomy),LAVH(laparoscopically assisted vaginal hysterectomy) were performed for uterine problems. Results:45.09% of the gynecologic operations in our hospital were performed laparoscopically, with the success rate of 98.8%. Five showed complications, the rate being 2.9%,2 subcutaneous emphysema，1 subcutaneous hematoma， 1 umbilical wound split open,1 pelvic hematoma.Conclusion:The results suggest that laparoscopic operation is safe and feasible in treating most gynecologic diseases if the indications are well selected. 　　Key words： Gynecologic surgery; Laparoscopy 　　我院自2004年1月至2005年11月共实施妇科腹腔镜手术170例,效果满意，现报道如下。 　　1 资料和方法 　　1.1 一般资料：本组患者年龄17～64岁,平均年龄38.7岁。有盆腔手术史者12例。疾病构成种类见表1，腹腔镜手术术式见表2，同一病例按所行最大手术归类,部分病例行两种或两种以上手术。 　　表1 疾病构成种类及构成比（略） 　　表2 腹腔镜手术术式（略） 　　1.2 方法：采用德国Storz公司生产的腹腔镜仪器设备，全部病例均选择全身麻醉，腹腔内压力保持在12～14mmHg,脐部或脐孔上3cm置入腹腔镜,在麦氏点及其左下腹对称点及耻骨联合左上缘分别做5mm、10mm、5mm穿刺孔,手术步骤按手术类别简述如下。 　　1.2.1 异位妊娠手术：对