LEEP手术并发症原因分析

目的:分析LEEP手术术中、术后并发症的发生原因,为防治手术并发症提供依据。方法:采用LEEP术对483例宫颈病变患者进行治疗,观察并发症发生情况并分析原因。结果:LEEP手术术中出血19例(3.93%),与术前阴道及宫颈感染、病变面积大、病变在宫颈管深部有关;术后出血16例(3.31%),与术中电凝范围大、术后创面感染等因素有关;宫颈管狭窄、粘连15例(3.10%),与创面感染、术后出血时间长、患者年龄近更年期及锥切深度有关;宫颈内膜异位症19例(3.93%),与月经周期短、手术时间延后,以及切除范围大、术后脱痂出血时间长、创面感染等因素使创面愈合时间延长有关;LEEP手术还对妊娠和分娩存在潜在影响。结论:掌握LEEP手术指征及手术时机,规范手术步骤,加强术后管理,可减少手术并发症的发生率,提高手术成功率。

Analysis of complications of loop electrosurgical excision procedure

Objective:To analyze the causes of complications of loop electrosurgical excision procedure(LEEP) in treatment of cervical diseases and give some preventive measures.Methods:483 patients with cervical diseases were treated with LEEP.The causes of complications were retrospectively analyzed.Results:19 patients had bleeding in LEEP procedure(3.93%),and the intraoperative bleeding was correlated with preoperative cervical infection,large lesion,and lesion in deep part of cervical canal.16 cases had bleeding after LEEP procedure(3.31%),and the postoperative bleeding was correlated with large extent of electric coagulation in operation and infection in wound surface after operation.Cervical canal stenosis and adhesion occurred in 15 patients(3.10%) and it was related with infection in wound surface,long time of bleeding after operation,age near climacteric period,and depth of conical knifing. Cervix endometriosis occurred in 19 cases(3.93%),and it was correlated with prolonged healing time of wound surface.LEEP had potential influence in pregnancy and delivery.Conclusion:LEEP is a safe and effective method for the treatment of cervical diseases.Careful selection of the operative indication,standardization of the operative procedures,and to strengthen postoperative management can decrease the occurrence of complications and get satisfactory effects.