微型小头弯分离钳在妇科腹腔镜手术中的应用

发布时间：2018-11-16 19:02

【摘要】：目的评价微型小头弯分离钳在腹腔镜下输卵管吻合术,输卵管伞端造口术,输尿管隧道处理3种术式的临床应用的价值。方法实验组应用微型小头弯分离钳在腹腔镜下行输卵管吻合术(18例),输卵管伞端造口术(22例)和输尿管隧道处理(28例),对照组使用常规器械,其中输卵管吻合术(16例),输卵管伞端造口术(20例),输尿管隧道处理(26例)。结果输卵管吻合术:实验组手术时间(58.7±9.2)min,明显短于对照组(77.9±9.6)min(t=-5.951,P=0.000);输卵管通畅率明显高于对照组(Fisher’s检验,P=0.000)。输卵管伞端造口术:实验组手术时间(49.6±5.2)min,明显短于对照组(65.5±6.6)min(t=-8.713,P=0.000);输卵管通畅率明显高于对照组(Fisher’s检验,P=0.043)。输尿管隧道处理:实验组手术时间(35.7±5.3)min,明显短于对照组(52.9±5.4)min(t=-11.808,P=0.000);术中出血量(10.4±4.4)ml,明显少于对照组(18.1±8.4)ml(t=-4.263,P=0.000);术后输尿管损伤率、宫旁切除范围2组均无明显差异(Fisher’s检验,P=0.227;t=1.797,P=0.078)。结论腹腔镜下输卵管吻合术和输卵管伞端造口术中应用微型小头弯分离钳,操作更加简便、快捷,缩短手术时间,术后输卵管通畅率高,适用于所有输卵管复通及输卵管伞端阻塞患者的手术;输尿管隧道处理应用微型小头弯分离钳可缩短手术时间,减少手术出血量,值得临床推广。
[Abstract]:Objective to evaluate the clinical value of mini-small head bending forceps in laparoscopic salpingostomy, fallopian tube end ostomy and ureteral tunnel management. Methods Laparoscopic tubal anastomosis (18 cases), fallopian tube end oviduct ostomy (22 cases) and ureteral tunnel (28 cases) were performed in the experimental group with small head bending forceps. The control group was treated with conventional instruments. Among them, oviduct anastomosis (16 cases), fallopian tube end ostomy (20 cases) and ureteral tunnel (26 cases) were performed. Results the operative time of tubal anastomosis in the experimental group (58.7 卤9.2) was significantly shorter than that in the control group (77.9 卤9.6) min (/ t) and the patency rate of the fallopian tube was significantly higher than that in the control group (Fisher's test, P0. 000). The operation time of the experimental group was (49.6 卤5.2) min, significantly shorter than that of the control group (65.5 卤6.6) min (/ t) and the patency rate of the fallopian tube was significantly higher than that of the control group (Fisher's test, P0. 043). Ureteral tunnel management: the operative time of the experimental group (35.7 卤5.3) min, was significantly shorter than that of the control group (52.9 卤5.4) min (/ t) -11.808 (P < 0.01). The intraoperative bleeding volume (10.4 卤4.4) ml, was significantly lower than that in the control group (18.1 卤8.4) ml (/ t -4.263), and there was no significant difference in postoperative ureteral injury rate and paracervical resection range between the two groups (Fisher's test, P = 0.227). T = 1.797 (P = 0.078). Conclusion it is more convenient, faster and shorter to use microcupolis forceps in laparoscopic fallopian tube anastomosis and salpingostomy, and the rate of tubal patency after operation is high. It is suitable for all patients with fallopian tube recanalization and obstruction of fallopian tube end. The treatment of ureteral tunnel with miniature small head bending forceps can shorten the operation time and reduce the amount of operative bleeding, so it is worth popularizing in clinic.
【作者单位】：佛山市南海区人民医院;南方医科大学附属南海医院妇科;
【分类号】：R713

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