妇科腹腔镜手术并发症原因分析

摘要

Objective: Reason analysis and countermeasure research about complications of laparoscopic gynecologic operation. Methods: 951 laparoscopic gynecologic surgeries and complications were analyzed retrospectively from June 2006 to August 2012. Results Complications occurred in cases, the overall complication rate was 3. 25%. The complication rate of laparoscopic annex operation was the least (1. 88%) ,the next was in the laparoscopic myomectomy(3. 22%) and laparoscopically subtotal hysterectomy(3. 22%); The complication rate in total laparoscopic hysterectomy and laparoscopic subradical or radical hysterectomy with Pelvic lymph node dissection was 6. 58% and 33. 33% ,and more than others,The complications included 6 case of complications of CO2 pneumoperitone-um,9 case of blood vessel and viscera injury,5 case of thermal injury and electric injury. 11 cases of postoperative complications. Conclusions:With the increase of the difficulty of laparoscopic gynecologic surgery,the complications areincreased. We should select indication carefully,especially in the cases which had histories of pelvic,abdominal operations and severe adhesion or more difficult operations. We should prevent and treat the complications of laparoscopic gynecologic surgery actively.%目的:探讨妇科腹腔镜手术常见并发症的原因.方法:对两家医院妇科2006年6月至2012年8月完成的951例妇科腹腔镜手术及其并发症进行回顾性分析.结果:953例腹腔镜手术中有31例出现并发症,发生率为3.25％.附件手术并发症发生率最低1.88％,其次是子宫肌瘤剔除和子宫次全切除术,为3.22％,全子宫切除和子宫(次)广泛切除术加盆腔淋巴结清扫术的并发症较前三者明显增高,分别为6.58％和33.33％,子宫(次)广泛切除术加盆腔淋巴结清扫术并发症最多、手术风险最大.31例并发症包括与CO2气腹相关的并发症6例,血管脏器损伤9例,热损伤和电损伤5例,术后并发症11例.结论:腹腔镜手术难度越大,手术并发症越多,应严格适应证选择,尤其是既往有腹腔或盆腔手术史、腹腔或盆腔粘连明显的手术.妇科腹腔镜手术并发症应该重视预防并积极予以有效干预处理.