妇科腹腔镜手术中经脐套管针开放性置入技术与传统穿刺法的比较研究

目的通过妇科腹腔镜手术中经脐套管针开放性置入技术与传统穿刺法的安全性和有效性比较,探讨开放性腹腔镜置入技术的可行性。方法连续性选择我院2009年5月至2012年5月间我院妇科腹腔镜手术病例,其中采用经脐套管针开放性置入组(研究组)及传统穿刺组(对照组)各入组200例进行比较分析。结果两组比较研究组体重指数及腹部手术史稍高于对照组(P<0.05),在穿刺过程中,两组一次成功率、穿刺不顺利率两组比较相似(P>0.05),但研究组较对照组缩短了第一穿刺时间(P<0.05),两组术中并发症及术后病率比较差异无统计学意义。结论应用套管针开放性置入技术缩短了第一穿刺时间,与传统穿刺方法比较并无增加术中并发症及术后病率,且对于肥胖、腹部手术史患者亦适合,可以作为一种较为安全而有效的腹腔镜第一穿刺方法。

A Comparative Study of Open Trocar Placement Technology via the Umbilical and the Traditional Puncture in Gynecological Laparoscopic Surgery

Objectives To compare the safety and efficiency through the umbilical trocar open insertion technology and traditional puncture in gynecological laparoscopy. Methods Gynecological Laparoscopic surgery patients in our hospital from May 2009 to May 2012 were continuitily selected and divided into the study group （trocar open insertion group） and control group （traditional puncture group） , each group was 200 cases. Results Body mass index and abdominal surgical history of the study group is slightly higher than the control group （P〈0.05） .the two groups on only once puncture success rate and 2-3 times puncture success rate are similar （P〉0.05）; However, the study group shortened the puncture process time than in the control group （P〈0.05）. No significant difference in the two groups of intraoperative complications and postoperative morbidity. Conclusion The trocar open insertion technology shortened the first puncture time of laparoscopy, and this technology didn＇t increase intraoperative complications and postoperative morbidity than traditional puncture method, this technique was also applicable to patients with obesity, history of abdominal surgery. Therefore, the trocar open insertion technology can be used as a relatively safe and effective laparoscopic puncture method.