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目的探讨腹腔镜手术并发症的相关情况及预防和减少其发生的有关措施。方法对广东医学院附属医院妇科1998年5月至2003年5月785例腹腔镜手术及21例并发症情况进行回顾性分析。结果785例妇科腹腔镜手术中,并发症发生率为2.68%(21/785)。除外不需处理的6例皮下气肿、肩痛外,实际发生率为1.91%。出血、感染及损伤等严重并发症发生率为1.40%。腹腔镜下疑难手术如腹腔镜辅助阴式子宫切除术及腹腔镜下子宫次全切除术等并发症发生率为1.66%(13/785),其他类手术并发症8例,发生率为1.02%。两者比较差异有显著性意义(P<0.01)。异位妊娠术后继发腹腔妊娠2例,持续性异位妊娠1例。结论腹腔镜手术并发症与手术难度有关。提高医生的内镜手术技能和手术技巧,可减少并发症的发生,降低并发症造成的危害。
Objective To investigate the related situation of complications of laparoscopic surgery and the related measures to prevent and reduce its occurrence. Methods A retrospective analysis was performed on 785 cases of laparoscopic surgery and 21 cases of complications in Department of Gynecology, Affiliated Hospital of Guangdong Medical College from May 1998 to May 2003. Results In 785 cases of gynecological laparoscopic surgery, the complication rate was 2.68% (21/785). Except for 6 cases without subcutaneous emphysema, shoulder pain, the actual incidence was 1.91%. The incidence of serious complications such as bleeding, infection and injury was 1.40%. Laparoscopic surgery such as laparoscopic assisted vaginal hysterectomy and laparoscopic hysterectomy and other complications was 1.66% (13/785), other types of surgical complications in 8 cases, the incidence was 1.02% . The difference was significant (P <0.01). 2 cases of secondary abdominal pregnancy after ectopic pregnancy, 1 case of persistent ectopic pregnancy. Conclusion Laparoscopic surgery complications and surgical difficulty. Improve the doctor’s endoscopic surgery skills and surgical skills, can reduce the incidence of complications and reduce complications caused by the harm.