盆腹腔手术史对腹腔镜手术质量以及盆腹腔粘连的影响(1)
[摘要] 目的 探究有盆腹腔手术史的患者对再次腹腔镜手术的影响。方法 整群选取并回顾分析2014年1月—2015年12月期间在该院行腹腔镜手术的患者1 843例，其中420例(22.79%)患者既往有盆腹腔手术史(研究组)，1 423例(77.21%)患者无盆腹腔手术史(对照组)。比较两组患者腹腔镜手术情况。 结果 研究组粘连发生率为71.9%，明显高于对照组的7.52%，组间比较差异有统计学意义(P<0.01)；既往盆腹腔手术类型、次数及手术方式对盆腹腔粘连的发生率及粘连程度有明显的影响；研究组脐上穿刺发生率和中转开腹率分别为22.86%和0.71%，明显高于对照组的3.3%和0.14%，组间比较均差异有统计学意义(P<0.01)；研究组患者并发症发生率、手术时间、术中出血量及住院时间分别为0.71%、(90.52±8.74)min、(117.38±14.65)mL和(8.14±2.57)d，与对照组0.63%、(89.78±8.52)min、(115.84±15.27)mL和(7.93±2.48)d比较，差异无统计学意义(P>0.05)。结论 有既往盆腹腔手术史者再次行腹腔镜手术是可行的，但术中需要积极预防脐上穿刺及中转开腹情况的发生。
[关键词] 腹腔镜；盆腹腔粘连；盆腹腔手术史
[中图分类号] R713 [文献标识码] A [文章编号] 1674-0742(2016)06(b)-0082-03
[Abstract] Objective Study the influence of pelvic operation history to the quality of Laparoscopic operation and pelvic adhesions. Methods Group selection retrospective analysis from January 2014 to December 2014 line in our hospital during laparoscopic surgery in patients 1843 cases， 420 cases (22.79%)， the patient has a history of abdominal surgery (group)， 1423 (77.21%) patients with no history of basin of laparoscopic surgery (control group). Compare two groups of patients with laparoscopic surgery. Results The research group conglutination was 71.9%， significantly higher than the control group of 7.52%， comparison between groups，the difference was statically signifccant(P<0.01)； Always basin celiac surgery type， number and operation method of basin to the incidence of abdominal adhesions， and has distinct effect on the adhesion degree； The research group on the navel puncture and transfer laparotomy incidence rate were 22.86% and 0.71%， significantly higher than the control group were 3.3% and 0.14%， comparison between groups，the difference was statically signifccant(P<0.01)； The research group in patients with complications， operation time， intraoperative blood loss， hospital stay were 0.71%， (90.52±8.74) min， (117.38±14.65)mL and (8.14±2.57)d， and compare with the control group of 0.63%， (89.78±8.52) min and (115.84±15.27)ml and (7.93±2.48)d， the difference wasn't Statically Signifccfant (P>0.05). Conclusion Person who has a history of basin celiac surgery again line of laparoscopic surgery is feasible， but in need to actively prevent navel puncture and transfer laparotomy.
[Key words] Laparoscope； Pelvic adhesions； Pelvic peritoneal operation history
盆腔开腹手术损伤大，术后恢复较慢且住院时间长，增加了患者痛苦时程，而腹腔镜大大改善了这一系列情况，能够使患者早日康复回归健康生活[1]。以前的盆腹腔手术会引发盆腹腔粘连从而使得盆腔解剖结构改变，导致下次手术增加器官暴露的困难性，以及在粘连分解时发生伤害。经过医学的发展，当下有盆腹腔手术史已经不能够对腹腔镜手术造成较大影响，腹腔镜可以安全、有效的给予有盆腹腔手术史的患者进行手术。该文回顾分析2014年1月—2015年12月期间在该院行腹腔镜手术的患者1 843例的资料及手术情况，有盆腹腔手术史的患者对该次腹腔镜手术的影响，现报道如下。 (袁浩鑫 张三元)
[关键词] 腹腔镜；盆腹腔粘连；盆腹腔手术史
[中图分类号] R713 [文献标识码] A [文章编号] 1674-0742(2016)06(b)-0082-03
[Abstract] Objective Study the influence of pelvic operation history to the quality of Laparoscopic operation and pelvic adhesions. Methods Group selection retrospective analysis from January 2014 to December 2014 line in our hospital during laparoscopic surgery in patients 1843 cases， 420 cases (22.79%)， the patient has a history of abdominal surgery (group)， 1423 (77.21%) patients with no history of basin of laparoscopic surgery (control group). Compare two groups of patients with laparoscopic surgery. Results The research group conglutination was 71.9%， significantly higher than the control group of 7.52%， comparison between groups，the difference was statically signifccant(P<0.01)； Always basin celiac surgery type， number and operation method of basin to the incidence of abdominal adhesions， and has distinct effect on the adhesion degree； The research group on the navel puncture and transfer laparotomy incidence rate were 22.86% and 0.71%， significantly higher than the control group were 3.3% and 0.14%， comparison between groups，the difference was statically signifccant(P<0.01)； The research group in patients with complications， operation time， intraoperative blood loss， hospital stay were 0.71%， (90.52±8.74) min， (117.38±14.65)mL and (8.14±2.57)d， and compare with the control group of 0.63%， (89.78±8.52) min and (115.84±15.27)ml and (7.93±2.48)d， the difference wasn't Statically Signifccfant (P>0.05). Conclusion Person who has a history of basin celiac surgery again line of laparoscopic surgery is feasible， but in need to actively prevent navel puncture and transfer laparotomy.
[Key words] Laparoscope； Pelvic adhesions； Pelvic peritoneal operation history
盆腔开腹手术损伤大，术后恢复较慢且住院时间长，增加了患者痛苦时程，而腹腔镜大大改善了这一系列情况，能够使患者早日康复回归健康生活[1]。以前的盆腹腔手术会引发盆腹腔粘连从而使得盆腔解剖结构改变，导致下次手术增加器官暴露的困难性，以及在粘连分解时发生伤害。经过医学的发展，当下有盆腹腔手术史已经不能够对腹腔镜手术造成较大影响，腹腔镜可以安全、有效的给予有盆腹腔手术史的患者进行手术。该文回顾分析2014年1月—2015年12月期间在该院行腹腔镜手术的患者1 843例的资料及手术情况，有盆腹腔手术史的患者对该次腹腔镜手术的影响，现报道如下。 (袁浩鑫 张三元)