宫腹腔镜手术治疗80岁以上老年患者妇科疾病的安全性分析

发布时间：2018-07-17 01:41

【摘要】：目的探讨80岁以上老年患者妇科疾病行宫腹腔镜手术的安全性。方法对我院妇科微创中心2013年1月~2017年1月宫腹腔镜手术治疗12例年龄≥80岁老年患者妇科疾病进行回顾性分析。结果 7例宫腔镜手术时间(30.0±10.7)min,3例腹腔镜手术时间分别为30、45、65 min,1例宫腹腔镜联合手术时间为55 min,1例宫腔镜手术时间为30min,再次腹腔镜手术时间为70 min。7例宫腔镜手术出血量为(20.0±10.7)ml,3例腹腔镜手术出血量分别为30、35、50 ml,1例宫腹腔镜联合手术出血量60 ml,1例宫腔镜手术出血量10 ml,再次腹腔镜手术出血量100 ml。7例宫腔镜手术病理:2例萎缩性子宫内膜,3例子宫内膜息肉,1例宫颈息肉,1例子宫内膜息肉和宫颈息肉;3例腹腔镜手术病理均为良性浆液性囊腺瘤;1例宫腹腔镜联合手术为萎缩性子宫内膜及良性浆液性囊腺瘤;1例为子宫内膜样腺癌(高分化)。术后无前列腺电刀综合征、子宫穿孔、大出血、感染及静脉血栓性疾病等并发症。12例随访(19.8±10.7)月,未见异常。结论在充分评估患者手术风险的基础上,宫腹腔镜手术对于诊治80岁以上老年患者妇科疾病具有创伤小、恢复快等优点,疗效肯定,安全可行。
[Abstract]:Objective to investigate the safety of laparoscopic surgery for gynecological diseases in elderly patients over 80 years old. Methods from January 2013 to January 2017, 12 cases of gynecological diseases in gynecological minimally invasive center of our hospital were retrospectively analyzed. Results the operative time of hysteroscopy in 7 cases was (30.0 卤10.7) min. The operative time of laparoscopic surgery in 3 cases was 30 ~ 45 ~ 65 min respectively. The time of combined hysteroscopy operation was 55 min and the time of hysteroscopic surgery was 30 min in 1 case, and 70 cases in bleeding under hysteroscope operation again. The volume of bleeding in 3 cases of laparoscopic surgery was (20.0 卤10.7) ml. The volume of bleeding in 3 cases of laparoscopic surgery was 30 ~ 35ml / 50 ml respectively. The bleeding volume of 1 case of hysteroscopic surgery was 60 ml / ml and that of 1 case of hysteroscopic surgery was 10 ml / 10 ml, respectively. The volume of bleeding of another laparoscopic operation was 100 ml.7 (n = 2) in atrophic uterus. 3 cases of endometrial polyps 1 case of cervical polyp 1 case of endometrial polyp and 3 cases of cervical polyp were all benign serous cystadenoma and 1 case of hysteroscopy combined with laparoscopy for atrophic endometrium and benign serous fluid. One case of sex cystadenoma was endometrial adenocarcinoma (highly differentiated). No postoperative complications, such as electrosurgical syndrome of prostate, uterine perforation, massive hemorrhage, infection and venous thrombotic disease, were observed in 12 patients (19.8 卤10.7) months. Conclusion on the basis of fully evaluating the risk of surgical operation, hysteroscopy has the advantages of less trauma and quick recovery in the diagnosis and treatment of gynecological diseases in elderly patients over 80 years of age. The curative effect is definite and safe and feasible.
【作者单位】：北京大学航天临床医学院航天中心医院妇产科;首都医科大学附属北京妇产医院妇科微创中心;
【基金】：国家科技支撑计划(2014BAI05B03) 首都卫生发展科研专项(2014-1-2112) 北京市医院管理局临床医学发展专项(ZYLX201406)
【分类号】：R713

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