基层医院腹腔镜手术治疗妇科附件疾病应用体会.docVIP

基层医院腹腔镜手术治疗妇科附件疾病应用体会【摘要】 目的：探讨基层医院腹腔镜手术在妇科附件疾病治疗中的可行性和安全性。方法：回顾性分析腹腔镜妇科附件手术89例的术式及并发症的治疗情况。结果：腹腔镜手术可替代部分附件开腹手术，具有出血少、痛苦小、恢复快、住院日短等优点，可通过严格掌握手术指征、熟练操作和器械性能而预防其并发症。结论：腹腔镜手术在基层医院妇科附件疾病治疗中是安全可行的。 【关键词】 基层医院； 妇科附件疾病； 腹腔镜手术 Application Experience of Laparoscopy Operation in Treatment of Gynecologic Adnexal Diseases / YE Shao-hua.// Medical Innovation of China，2012，9(14)：114-115 【Abstract】 Objective：To study the feasibility and safety of the laparoscopic surgical treatment of gynecological accessories in basic-level hospitals. Methods：The ways of operation and complications on 89 cases with the laparoscopic surgical treatment of gynecological accessories were analyzed retrospectively evaluated. Results：Partial operations could be made with a laparascope and the complications could be controlled and prevented with skillfully performing and rich experience. Compared with the incision of abdomen， the operations with a laparoscope had characteristics of its less bleeding， less pain suffering， quicker recovery， shorter hospital staying and lower morbidity. Conclusion：The operation with a laparoscope is claimed to be mildly wounded with diagnosis， treatment together. It will be the best way to treat the diseases of adnexa uteri. 【Key words】 Basic-level hospitals； Gynecological accessories diseases； Laparoscopic surgery First-authors address： Shucheng Peoples Hospital in Anhui Province，Shucheng 231338，China doi：10.3969/j.issn.1674-4985.2012.14.076 腹腔镜手术由于出血少、痛苦小、恢复快、住院日短等优点在妇科附件疾病治疗中越来越多地替代开腹手术[1]。但由于患者因盆腔粘连、病变复杂、技术水平、担心需中转开腹等缘故，基层医院的开展常常受限，笔者所在科自2008年开展腹腔镜妇科附件手术89例，临床效果满意，现报道如下。 1 资料与方法 1.1 一般资料 2008年5月-2011年5月笔者所在科行附件手术治疗患者共295例。89例腹腔镜手术，年龄19~68岁，平均36岁；患者均有完整病史、实验室检查、麻醉和手术记录及随诊情况。 1.2 手术指征 应用德国stoze腹腔镜及康基配套手术器械。89例腹腔镜手术病例中，其中异位妊娠行输卵管切除术24例，输卵管造口及伞部取胚6例，卵巢囊肿25例(包括卵巢巧克力囊肿剔除术11例，卵巢畸胎瘤8例，卵巢单纯性囊肿剥除术3例，卵巢浆液性囊腺病剥除术3例)，不孕症10例，子宫内膜异位症及囊肿9例，卵巢肿瘤1例，输卵管积水7例，黄体破裂4例，输卵管脓肿3例。 1.3 手术方法 患者均行全身麻醉，手术过程中连续监测心电、血氧饱和度。常规消毒，禁食6 h，置导尿管，气腹穿刺Veress针于脐缘穿刺，确定入腹腔后CO2充气，