腹腔镜子宫切除术后近期并发症的临床分析

目的 分析行腹腔镜子宫切除术的患者，术后近期并发症发生种类、原因及特点，探讨相应的处理方式和策略。方法 对我院2012年1月至2014年7月共318例因良性子宫疾病行腹腔镜下子宫切除术的病例，对术后临床资料进行回顾性分析。结果 318例均成功实施腹腔镜手术，术后近期近期发生并发症有21例,发生率6.60％。并发症种类主要为皮下气肿2例,皮下出血3例,肠道损伤（肠瘘）1例,膀胱输尿管损伤（膀胱输尿管瘘）4例，盆腔及阴道残端感染4例，泌尿道感染1例，腹壁切口感染2例，阴道残端出血2例，切口疝1例，麻痹性肠梗阻1例。结论:腹腔镜子宫切除手术广泛开展且日渐取代传统开腹手术，其术后并发症的发生仍不容忽视。术后发生近期并发症主要有皮下气肿、皮下血肿、肠瘘、膀胱输尿管瘘、盆腔及阴道残端感染、泌尿道感染、腹部切口感染、阴道残端出血、切口疝、肠梗阻等。发生原因与手术适应症的选择、手术的难易程度、手术医生的操作经验、手术器械的完善、围手术期的护理等有均有关。掌握特点，积极预防，可减少并发症的发生。

Clinical Analysis of Gynecologic Laparoscopic hysterectomy Surgery-related Complications

Objective analyze postoperative complication types, causes and characteristics, and discuss appropriate treatment strategies of the patients underwent laparoscopic hysterectomy. Methods From January 2012 to July 2014 a total of 318 cases of benign uterine disease because laparoscopic hysterectomy patients, postoperative clinical data were retrospectively analyzed. Results 318 cases of successful implementation of laparoscopic surgery in March occurred in 21 cases of postoperative complications, the incidence of 6.60%. The main categories of subcutaneous emphysema complications two cases, three cases of subcutaneous hemorrhage, intestinal injury (fistula) 1 cases, vesicoureteral injury (vesicoureteral fistula) four cases, pelvic and vaginal stump four cases of infection, urinary tract infection 1 cases, 2 cases of abdominal incision infection, vaginal bleeding stump two cases, one case of incisional hernia, one case of paralytic ileus. CONCLUSIONS: Laparoscopic hysterectomy extensive and increasingly replace traditional open surgery, postoperative complications occurred can not be ignored. Recent major postoperative complications subcutaneous emphysema, subcutaneous hematoma, intestinal fistula, vesicoureteral fistula, pelvic and vaginal stump infections, urinary tract infections, abdominal wound infection, vaginal bleeding stump, incisional hernia, intestinal obstruction. The cause and the choice of surgical indications, ease of operation, operating experience of the surgeon, and improve surgical instruments, perioperative care, there are related. Grasp the characteristics of active prevention, can reduce the incidence of complications.