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妇科手术中大血管的损伤在常规性手术,即使大如子宫颈癌根治术,也是极罕见的。但在较晚期恶性肿瘤,特别是有腹膜后淋巴转移者,良性肿瘤而有广泛炎性粘连者或并发子宫内膜异位症者,则在分离病灶中有可能发生。至于简单的剖腹手术,由于病人消瘦或腹壁薄弱,在重按下切皮伤及大血管者,临床上亦偶有发生,这种情况往往是由于经验不足或操作不慎所致。手术中一旦发生大血管损伤,由于出血汹涌,若不及时采取有效止血措施,患者往往立即陷于失血性休克,甚至达到不可逆程度,而死于手术台上;即或经过抢救,得以挽救生命,亦可因休克深重、过久,而遗留脑缺氧或肝、肾功能障碍以至全身代谢失调等并发症。因此,分秒必争地采取有效止血措施是关键,而及时补充血容量与适当麻醉又为关键中之关键。前
Large blood vessels in gynecological surgery in the conventional surgery, even as large as cervical cancer radical surgery is also extremely rare. However, in more advanced malignancies, especially those with retroperitoneal lymphatic metastasis, benign tumors with extensive inflammatory adhesions or complicated with endometriosis, it is possible to separate lesions. As for the simple laparotomy, due to the patient’s weight loss or weakness of the abdominal wall, in the press and cut the skin and large blood vessels, the clinical occasionally occur, this situation is often due to lack of experience or inadvertently caused. In the event of major vascular injury, due to bleeding surges, if not promptly take effective hemostatic measures, patients often immediately hemorrhagic shock, or even irreversible degree, and died in the operating table; that is, or after the rescue, to save lives, but also May be due to deep shock, too long, and left cerebral hypoxia or liver, kidney dysfunction and systemic complications such as metabolic disorders. Therefore, every second to take effective measures to stop bleeding is the key, and timely replacement of blood volume and appropriate anesthesia is the key of the key. before