腹腔镜下全子宫切除术68例疗效和并发症防治

目的探讨腹腔镜下全子宫切除手术的临床疗效和并发症情况。方法入选2011年01月～2011年8月在某院行腹腔镜下全子宫切除手术患者68例,以及同期行开腹子宫全切除手术患者59例,比较两组患者临床疗效和并发症发生情况。结果两组患者手术均顺利完成,68例采用腹腔镜手术的患者无1例出现中转开腹手术。采用腹腔镜手术患者手术时间、术中出血量、肛门排气时间和住院时间均较采用开腹手术患者少,差异有统计学意义(P﹤0.05)。采用开腹手术59例患者术后出现并发症5例,发生率为8.5%;采用腹腔镜手术68例患者术后发生并发症3例,发生率为4.4%,差异有统计学意义(P﹤0.05)。腹腔镜手术患者术后并发症3例中输尿管扭曲积水、输尿管阴道瘘、膀胱阴道瘘各1例。结论术前严格掌握患者的适应症,术中严格按照手术步骤,对于减少患者术中、术后并发症具有重要的临床意义。

Curative effect and prevention of complications of 68 cases of laparoscopic total hysterectomy

OBJECTIVE To explore the clinical efficacy and complications of laparoscopic total hysterectomy.METHODS Selected 68 cases underwent laparoscopic hysterectomy operation from Jan.2011 to Aug.2011 in our hospital,and at the same time,open hysterectomy operation in 59 patients,compared the clinical efficacy and complications of patients in two groups.RESULTS The operations of the two groups were successfully performed.In 68 patients with laparoscopic operation,none case changed to open operation.The operation time,intraoperative bleeding,anal exhaust time and hospitalization stay in patients with laparoscopic operation were fewer than those of patients with open operation,P﹤0.05.5 cases had postoperative complications in 59 patients using open operation,incidence of 8.5%;3 cases of postoperative complications occurred in 68 patients of adoption of laparoscopic operation,incidence of 4.4%,P﹤0.05.There were 3 cases with postoperative complications including ureteral kinking hydrocephalus,ureterovaginal fistula,vesicovaginal fistula in patients with laparoscopic operation.CONCLUSION Strict control in indications of patients in surgery,and conducting operation steps have important clinical significances for patients to reduce intraoperative,postoperative complications.