盆腹腔手术史对腹腔镜手术质量以及盆腹腔粘连的影响

目的：探究有盆腹腔手术史的患者对再次腹腔镜手术的影响。方法整群选取并回顾分析2014年1月—2015年12月期间在该院行腹腔镜手术的患者1843例，其中420例(22.79%)患者既往有盆腹腔手术史(研究组)，1423例(77.21%)患者无盆腹腔手术史(对照组)。比较两组患者腹腔镜手术情况。结果研究组粘连发生率为71.9%，明显高于对照组的7.52%，组间比较差异有统计学意义(P<0.01)；既往盆腹腔手术类型、次数及手术方式对盆腹腔粘连的发生率及粘连程度有明显的影响；研究组脐上穿刺发生率和中转开腹率分别为22.86%和0.71%，明显高于对照组的3.3%和0.14%，组间比较均差异有统计学意义(P<0.01)；研究组患者并发症发生率、手术时间、术中出血量及住院时间分别为0.71%、(90.52±8.74)min、(117.38±14.65)mL和(8.14±2.57)d，与对照组0.63%、(89.78±8.52)min、(115.84±15.27)mL和(7.93±2.48)d比较，差异无统计学意义(P>0.05)。结论有既往盆腹腔手术史者再次行腹腔镜手术是可行的，但术中需要积极预防脐上穿刺及中转开腹情况的发生。

The Influence of Pelvic Operation History to the Quality of Laparoscopic Operation and Pelvic Adhesions

Objective Study the influence of pelvic operation history to the quality of Laparoscopic operation and pelvic adhesions. Methods Group selection retrospective analysis from January 2014 to December 2014 line in our hospital dur-ing laparoscopic surgery in patients 1843 cases, 420 cases (22.79%), the patient has a history of abdominal surgery (group), 1423 (77.21%) patients with no history of basin of laparoscopic surgery (control group). Compare two groups of patients with laparoscopic surgery. Results The research group conglutination was 71.9%, significantly higher than the control group of 7.52%, comparison between groups,the difference was statically signifccant(P<0.01);Always basin celiac surgery type, num-ber and operation method of basin to the incidence of abdominal adhesions, and has distinct effect on the adhesion degree;The research group on the navel puncture and transfer laparotomy incidence rate were 22.86% and 0.71%, significantly higher than the control group were 3.3% and 0.14%, comparison between groups,the difference was statically signifccant(P<0.01);The research group in patients with complications, operation time, intraoperative blood loss, hospital stay were 0.71%, (90.52±8.74) min, (117.38±14.65)mL and (8.14±2.57)d, and compare with the control group of 0.63%, (89.78±8.52) min and (115.84±15.27)ml and (7.93±2.48)d, the difference wasn't Statically Signifccfant (P>0.05). Conclusion Person who has a history of basin celiac surgery again line of laparoscopic surgery is feasible, but in need to actively prevent navel puncture and transfer laparotomy.