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目的探讨妇产科腹腔镜手术的并发症发生情况。方法回顾性分析3962例妇科腹腔镜手术患者的临床资料及并发症发生情况。手术包括子宫全切除术618例(子宫切除组),子宫肌瘤剔除术842例(肌瘤剔除组),附件手术2421例(附件手术组),诊断性腹腔镜手术81例(诊断性手术组)。结果子宫切除组并发症发生率明显高于附件手术组、肌瘤剔除组及诊断性手术组,差异均有统计学意义(P<0.05)。3962例手术中发生各种并发症22例,发生率为0.56%。22例出现并发症的患者中,肠管损伤8例,膀胱损伤5例,输尿管损伤1例,腹腔内出血3例,腹壁切口出血1例,肠梗阻4例。结论应该积极预防腹腔镜手术并发症的发生,例如加强医师培训,熟悉局部解剖结构,有娴熟的手术经验,正确选择手术适应证,这些都是降低腹腔镜手术并发症的重要措施。
Objective To investigate the incidence of complications in obstetrics and gynecology laparoscopic surgery. Methods A retrospective analysis of 3962 cases of gynecological laparoscopic surgery in patients with clinical data and complications. Surgery included 618 cases of hysterectomy (hysterectomy group), 842 cases of myomectomy (myomectomy group), 2421 cases of accessory surgery (annex surgery group), 81 cases of diagnostic laparoscopic surgery (diagnostic surgery group ). Results The incidence of complications in hysterectomy group was significantly higher than that in the accessory surgery group, myomectomy group and diagnostic operation group (P <0.05). A total of 3962 cases of various complications occurred in 22 cases, the incidence was 0.56%. Among the 22 patients with complications, there were 8 cases of bowel injury, 5 cases of bladder injury, 1 ureter injury, 3 cases of intra-abdominal hemorrhage, 1 case of abdominal incision bleeding and 4 cases of intestinal obstruction. Conclusion The prevention of complications of laparoscopic surgery should be actively prevented. For example, strengthening the training of physicians, familiarizing with local anatomy, having skilled surgical experience and correctly selecting surgical indications are all important measures to reduce the complications of laparoscopic surgery.