腹腔镜手术的并发症以及预防措施（Complications and preventive measures of laparoscopic surgery）.docVIP

腹腔镜手术的并发症以及预防措施（Complications and preventive measures of laparoscopic surgery） 继续医学教育vol.20.no.50 16 知识篇 腹腔镜手术的并发症以及预防措施 腹腔镜手术的并发症以及预防措施 冷金花（中国医学科学院中国协和医科大学北京协和医院妇产科100730） 冷金花 作者简介 冷金花（1963 -），女，教 授，主任医师，主要方向 为妇科内镜和子宫内膜 异位症。现兼任国际妇 科内镜协会会员，亚太 地区内镜协会会员，中 华医学会妇产科分会中 青年委员，中华医学会 妇产科分会内镜学组委 员兼秘书等职。 腹腔镜手术在妇科领域的应用越来越广泛，许 多以前需开腹才能完成的手术，目前已逐渐被腹腔 镜手术所替代。腹腔镜手术有着众所周知的优点， 如切口小，手术效果好，术后痛苦少、恢复快，住 院时间短与传统的开腹手术相比，腹腔镜手术有。 以下特点：（1）手术非直视下进行，而是在二维 影像下的操作；（2）手术的体位不同，常需要头 低脚高位；（3）手术时需要气腹以暴露手术视 野；（4）手术器械常常为电手术器械或其他有能 量的器械；（5）一些手术并发症手术中不易发现 或容易忽略，而且腹腔镜处理并发症有一定困难， 常需要开腹完成。医生的手术经验、手术方式及范 Circumference is one of the key factors affecting the type and severity of complications. The Factors related to complications, their clinical manifestations and pre - treatment are reviewed The prevention and treatment measures are to reduce complications and improve the quality of medical treatment The key to ensure the safety of operation. 1 complication rate of laparoscopic surgery The A A G (L) report shows, Complication rates and mortality rates for laparoscopic surgery ranged from 1972 to 1988 0.68% and 25.0/10 million, down to 0.15% and 5.4/10 million. But complications in 1991 were 1.5 times higher than in 1988 [1]. The complications of laparoscopic surgery are related to the difficulty of the operation. Literature report The complication rate of diagnostic laparoscopy ranged from 0.19% to 0.27%, The complications of laparoscopic surgery ranged from 1.6% to 3%, among which The complications of LAVH were the highest, ranging from 9.4% to 16.6% [2~5]. In our hospital The total complication rate of laparoscopic surgery was 1.92%, including the appendix The complications of operation and myomectomy were 0.9% and 1.9% respectively, The complication of L A V H was 6.67% [6]. Although with laparoscopic surgery With the improvement of technique, the total complications of laparoscopic surgery showed a downward trend, However, with the extensive development of laparoscopic surgery, surgical indications contin