妇科腹腔镜手术３３７例临床分析_临床医学论文.docVIP

妇科腹腔镜手术３３７例临床分析_临床医学论文 妇科腹腔镜手术３３７例临床分析_临床医学论文 【摘要】 目的 探讨妇科腹腔镜手术治疗妇科疾病的可行性和临床价值。方法 总结妇科腹腔镜手术337例临床资料，分析其手术适应证、手术方式、并发症。结果 335例在腹腔镜下完成。2例因手术困难中转开腹。平均手术时间为（59.20±28.37）min，最长182min，最短19min。术中198例出血＜5 mL，5～50 mL者117例，50～150 mL者18例,150～300 mL者2例。术后平均住院时间（3.17±1.52）d。术后病率1.49%。手术并发症发生6例，并发症发生率1.79%。无远期并发症。结论 腹腔镜手术有创伤少、恢复快、并发症少等优点，值得推广。根据操作难度循序渐进地熟练操作技术，以进行相应手术，可获满意的疗效。 　　【关键词】腹腔镜；妇科手术 　　 　　【Abstract】ObjectiveTo explore the possibility and clinical value of gynecological laparoscopic operation.Methods Summarize the clinical data of 337 cases of gynecological laparoscopic operation analyze the indication,operative methods and complications.Results 335 cases are performed by laparoscopy, 2 cases are conversed to open abdomen because of operation difficulties. The average operation time is 59.20±28.37min,the longest time is 182 min,the shortest time is 19 min.There are 198 cases with blood loss less than 5ml, 117 cases with blood loss from 5ml to 50ml,18 cases with blood loss from 50ml to 150ml,2 case with blood loss from 150ml to 300ml.The average stay time in hospital is 3.17±1.52 days. The incidence after operation is 1.49%.Complications occurr in 6 cases,the complication rate is 1.79%. There are no long-term complications.Conclusion The gynecologic laparoscopic operation has many advantages, such as minimal wounding, speedy recovery, less complications, so it has high value in clinical practice. Mastery of operative laparoscopic techniques step by step along with the degree of surgical difficulty is mandatory, and can get satisfactory effect. 　　【Key words】Laparoscopy; Gynecologic surgery 　　 　　微创是现代外科发展的一种必然趋势。妇科腹腔镜手术是一种微创手术，以往许多开腹才能完成的妇科手术现在已经逐渐被腹腔镜手术所替代。2006年7月～2008年5月，简阳市人民医院妇产科共同完成腹腔镜手术337例，取得了良好的临床效果，现报道如下。 　　 　　1 临床资料 　　 　　1.1 一般资料 本组对象年龄17～63岁，平均（32.17±3 .22）岁,绝经后妇女11例，未婚者8例。其中经产妇264例，未产妇73例，既往有腹部手术史75例（其中有2次以上腹部手术史者21例）。 　　1.2 仪器设备 德国STORZE公司生产的全套腹腔镜电视摄像监视系统，00腹腔镜及手术器械。国产举宫器、子宫旋切器等。 　　1.3 疾病种类 本组疾病按术后确诊分类见表1。其中异位妊娠173例，卵巢囊肿（包括卵巢浆、粘液性囊腺瘤，巧克力囊肿）61例，卵巢畸胎瘤4