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目的:探讨妇科腹腔镜手术严重并发症发生的相关因素,预防严重并发症发生。方法:对2003年6月至2013年5月完成腹腔镜手术的3 210例患者资料作回顾性分析。结果:与附件手术比较,子宫切除术的并发症发生率及中转开腹率均明显升高(P<0.01);子宫肌瘤剔除术中转开腹率明显高于附件手术(P<0.01)。随术者操作经验增加及医疗器械的改进,2008年6月至2013年5月妇科腹腔镜手术例数较2003年6月至2008年5月增多,但子宫切除术严重并发症发生率明显减少(P<0.01)。结论:妇科腹腔镜手术严重并发症的发生及中转开腹率与手术种类、手术难度和术者操作水平有关。
Objective: To investigate the related factors of serious complications of gynecological laparoscopic surgery and prevent the occurrence of serious complications. Methods: The data of 3 210 patients who underwent laparoscopic surgery from June 2003 to May 2013 were retrospectively analyzed. Results: The incidence of complications and the rate of laparotomy in hysterectomy were significantly higher than those in the accessory surgery (P <0.01). The rate of laparotomy in hysterectomy was significantly higher than that in the accessory surgery (P <0.01). The number of gynecological laparoscopic surgery increased from June 2008 to May 2008 with the increase of operation experience and the improvement of medical devices from June 2008 to May 2013. However, the incidence of severe complications of hysterectomy was significantly decreased (P <0.01). Conclusions: The serious complications of gynecological laparoscopic surgery and the rate of laparotomy are related to the type of surgery, the difficulty of operation and the operation level of the surgeon.