妇科腹腔镜手术的临床分析_临床医学论文.docVIP

妇科腹腔镜手术的临床分析_临床医学论文 妇科腹腔镜手术的临床分析_临床医学论文 【摘要】 目的：总结妇科疾病腹腔镜手术的临床经验。方法：回顾分析２００４年５月至２００６年８月１４６例行腹腔镜手术的妇科疾病患者的临床资料，探讨腹腔镜下筋膜内子宫切除术、卵巢囊肿／畸胎瘤剥除术、附件切除术、子宫肌瘤切除术、输卵管造口通液术等手术方式。结果：患者术后住院３～１２d，常规使用抗生素３～５d，留置导尿管６～２４h。２例不孕症患者术后已足月分娩；１例阔韧带肌瘤因质地硬、包膜界限不清、剥离过程中出血多而中转开腹;３例切口感染，经用药后治愈；２例皮下气肿经处理次日消失。结论：病例选择是腹腔镜手术成功的关键。术者需经腹腔镜技能培训，有熟练开腹手术的经验和高超的腹腔镜操作水平以及手术组协调配合。只要适应证掌握得当，大部分妇科手术可在腹腔镜下完成，并可将并发症发生率降到最低。 【关键词】 妇科疾病 腹腔镜术 应证 　　Laparoscopic surgery for gynecologic diseases:a clinical analysis of 146 cases 　　【Abstract】 Ｏbjective:To summarize the clinical experiences of gynecologic laparoscopic surgery.Methods:A retrospective analysis was done in 146 patients with gynecologic diseases accepted laparoscopic surgery from May. 2004 to Aug. 2006.The laparoscopic surgery including intrafascial hysterectomy,oophorocystectomy,teratomaenucleation,adnexectomy,myomectomy,and hydrotubation were investigated retrospectively.Results:The duration of hospitalization was 312d,routine antibiotics application was 35d,and indwelling ureter was 624h.1 case of broad ligament muscular tumor was converted to open surgery becaues of hard tumor,obscure boundary and bleeding.Barrenness in 2 cases,incisional infection in 3 cases,and cutaneous emphysema in 2 cases were all cured.Conclusions:Strict control of indications is the key point of laparoscopic surgery.The operator shall be well trained and have sufficient experience of open surgery as well as sophisticated level.Whats more,the cooperation of the whole operation team is also important.As long as indication is correctly choosed,not only most gynecologic surgery would be well performed by laparoscopy,but also the incidence of operative complication would decrease to minimal level. 　　【Key words】 Gynecologic diseases; Laparoscopy;Indication 　　2004年5月至2006年8月我院为146例妇科疾病患者行腹腔镜手术，临床效果满意，现把结果报道如下。 　　1 资料与方法 　　 　　1.1 临床资料 本组患者１４６例，18～54岁，有腹部手术史7例。疾病种类包括：输卵管妊娠44例，宫角妊娠3例，卵巢妊娠1例，子宫内膜异位症15例，单纯卵巢囊肿19例，卵巢囊肿蒂扭转合并早孕1例，卵巢囊肿合并阑尾炎1例，子宫肌瘤31例，子宫肌瘤合并腺肌症4例，子宫内膜增生过长1例，黄体破裂1例，良性成熟畸