南山医院妇科近10年腹腔镜手术严重并发症的回顾性分析

发布时间：2018-02-08 10:06

本文关键词： 妇科手术腹腔镜并发症　出处：《中国微创外科杂志》2015年03期 　论文类型：期刊论文

【摘要】：目的探讨妇科腹腔镜手术的并发症及处理措施。方法对我院2005年1月~2014年5月9208例妇科腹腔镜手术的临床资料进行回顾性分析。结果发生并发症9例,发生率0.1%(9/9208)。3例大血管破裂术中发现,间断缝合修补,术后生命体征平稳;肠管损伤1例,术后第5天发现,经阴道行直肠阴道瘘修补术;输尿管损伤3例,1例术中发现,即行输尿管移植术,其余2例术后1~2周发现,术后2个月余行开腹输尿管膀胱植入术;膀胱损伤2例,均为术中发现,腹腔镜下行膀胱修补术。9例术后3个月随访恢复好。结论术中应仔细解剖,手术结束前常规查看输尿管蠕动及膀胱情况,检查导尿袋尿是否红色及有无气体,怀疑肠道损伤可肛门直肠充气看盆腔有无水泡产生。大血管损伤应保持镇定,一般可以在腹腔镜下行缝合术。
[Abstract]:Objective to investigate the complications and management of gynecologic laparoscopic surgery. Methods the clinical data of 9208 cases of gynecologic laparoscopic surgery from January 2005 to May 2014 in our hospital were retrospectively analyzed. The incidence rate was 0.1 / 9208.3 cases of major vascular rupture, interrupted suture repair, stable vital signs after operation, 1 case of intestinal injury, 5 days after operation, transvaginal repair of rectovaginal fistula, 3 cases of ureteral injury and 1 case of intraoperative ureteral injury. Ureteral transplantation was performed in the other 2 cases, and the other 2 cases were found 1 to 2 weeks after operation, and more than 2 months after operation were performed with open ureteral bladder implantation, and 2 cases with bladder injury were found during the operation. Conclusion careful dissection should be performed during the operation, and the ureteral peristalsis and bladder condition should be checked before the operation, and whether the ureteral pouch urine is red or not, and whether there is gas in the ureteral pouch urine, should be carefully dissected before the operation. Suspected intestinal injury can inflate the anorectum to see if there are vesicles in the pelvic cavity. Large vascular injuries should remain calm and can be sutured under laparoscopy.
【作者单位】：广东医学院附属深圳南山医院妇产科;
【基金】：深圳市科创委课题(项目编号:JCYJ20140411091151447)
【分类号】：R713

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