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泌尿外科腹腔镜手术并发症临床分析
引用本文:曹用立,张沛泳,朱继峰,秦允清,殷长军,吕强.泌尿外科腹腔镜手术并发症临床分析[J].实用医学杂志,2008,24(8):1396-1397.
作者姓名:曹用立  张沛泳  朱继峰  秦允清  殷长军  吕强
作者单位:1. 江苏省沛县人民医院泌尿外科,221600
2. 南京医科大学第一附属医院泌尿外科,210029
摘    要:目的 探讨泌尿外科腹腔镜手术并发症的发生原因及防治措施。方法 对2003年2月至2006年11月,我们施行的181例泌尿外科腹腔镜手术的并发症进行回顾性分析。结果 181例手术共发生并发症25例(13.8%),术中并发症17例,包括后腹腔间隙出血1例,胸膜损伤1例,曲卡穿刺损伤出血2例,气囊破裂2例,腹膜损伤6例,改开放手术5例。术后并发症8例,其中切口皮下气肿2例,尿漏2例,切口感染1例,CO2潴留、酸中毒1例,淋巴漏1例,术后继发出血1例。经相应处理均好转。结论 通过系统的操作训练和熟练的配合,熟悉腹腔镜及腹膜后腔镜下相应解剖结构,了解腹腔镜手术并发症的特点,严格掌握适应证,可减少泌尿外科腹腔镜手术并发症的发生。

关 键 词:腹腔镜  泌尿系疾病  并发症  
收稿时间:2007-10-8
修稿时间:2007年10月6日

Clinical analysis of laparoscopic complications in urologic surgery
Abstract:Objective To evaluate the causes,prevention and treatment of laparoscopic complications in urologic surgery. Methods From Feb 2003 to Nov 2006,181 urologic laparoscopies were performed, the intra- and post-operative complications were retrospectively reviewed and clinically analyzed. Results: Overall,25 cases(13.8%)had complications. Intraoperative complications occurred in 17 cases,including one case of retroperitoneal bleeding,one case of pleural injury, 2 cases of haemorrhage due to trocar punctura trauma, 2 cases of balloon rupture,6 cases of peritoneal injuries,5 cases converted to open surgery. Postoperative complications occurred in 8 cases,including 2 cases of subcutaneous emphysema,2 cases of urine leakage, one case of incisional wound infection , one case of CO2 retention and acidosis, one case of lymph leakage , one case of post-operative bleeding. Conclusions Systematic training of the surgeons, understanding the characteristics of laparoscopic complications in urologic surgery and strict adaptation disease and can reduce the occurrence of complications.
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