腹腔镜下全子宫切除术在既往开腹手术史患者中应用效果.docVIP

腹腔镜下全子宫切除术在既往开腹手术史患者中应用效果 　　[摘要]目的 探讨腹腔镜下全子宫切除术在既往开腹手术史者中的应用效果。方法 选取本院2011年1月～2016年3月的61例既往开腹手术史全子宫切除术患者作为研究对象，根据手术方式的不同分为开腹组（31例）和腹腔镜组（30例）。比较两组的手术并发症发生率、术中及术后相关指标、切口甲级愈合率。结果 腹腔镜组中，1例因肠管致密粘连中转开腹，其余均在腹腔镜下完成。腹腔镜组1例发生膀胱损伤，开腹组3例发生膀胱损伤，两组均无肠管损伤及输尿管损伤。腹腔镜组的手术时间短于开腹组，出血量少于开腹组，72 h内体温低于开腹组，差异有统计学意义（P0.05）。腹腔镜组的术后恢复自主活动时间、术后住院天数显著短于开腹组，差异有统计学意义（P0.05）。腹腔镜组的腹部切口甲级愈合率为100.0%，显著高于开腹组的80.6%，差异有统计学意义（P0.05）。结论 既往开腹手术史者可在腹腔镜下完成全子宫切除，手术时间、术后恢复自主活动时间、住院时间均缩短，腹部切口愈合良好，未增加手术风险，安全性好，值得临床推广应用。 　　[关键词]开腹手术史；全子宫切除术；腹腔镜 　　[中图分类号] R713.4+2 [文献标识码] A [文章编号] 1674-4721（2016）06（b）-0072-03 　　Application effect of laparoscopic total hysterectomy surgery in the patients with previous history of abdominal surgery 　　ZHANG Shu-zhen YANG Mei ZENG Chun-jie CHEN Xiao-lan 　　Department of Gynaecology，the Fifth Clinical Medical College of Fujian University of Traditional Chinese Medicine；the Second Hospital of Sanming City in Fujian Province，Yongan 366000，China 　　[Abstract]Objective To explore the application effect of laparoscopic total hysterectomy surgery in the patients with previous history of abdominal surgery.Methods 61 patients with previous history of abdominal surgery underwent total hysterectomy surgery from January 2011 to March 2016 in our hospital were selected and divided into the laparotomy group （31 cases） and the laparoscopic group （30 cases） according to the different operation methods.The incidence rate of postoperative complication，intraoperative and postoperative related indicators，the incision healing rate of grade A in the two groups was compared.Results One case of laparoscopic group transferred to laparotomy due to the dense bowel adhesion，the rest were completed under laparoscopy.There was one case of bladder injury in the laparoscopic group，three cases in the laparotomy group.There was no bowel injury and ureteral injury in the both groups.The operation time of the laparoscopy group was shorter than that of the laparotomy group，the amount of bleeding in the laparoscopy