[1]赵学英,冷金花,郎景和,等.妇科腹腔镜手术中血管损伤的临床分析[J].中国微创外科杂志,2005,05(3):178-180.
　Zhao Xueying,Leng Jinhua,Lang Jinghe,et al.A clinical analysis on vascular injuries during laparoscopic gynecologic surgery[J].Chinese Journal of Minimally Invasive Surgery,2005,05(3):178-180.
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妇科腹腔镜手术中血管损伤的临床分析()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
05
期数:
2005年3期
页码:
178-180
栏目:
出版日期:
2005-03-31

文章信息/Info

Title:
A clinical analysis on vascular injuries during laparoscopic gynecologic surgery
作者:
赵学英; 冷金花; 郎景和; 刘珠凤; 孙大为; 朱兰; 黄荣丽　
中国医学科学院,中国协和医科大学,北京协和医院妇产科,北京,100730
Author(s):
Zhao Xueying;  Leng Jinhua;  Lang Jinghe; et al.
Department of Obstetrics& Gynecology, Beijing Union Hospital, Chinese Academy of MedicalSciences, Beijing 100730, China
关键词:
腹腔镜;  妇科;  血管损伤
Keywords:
Laparoscopy; 　Gynecology; 　Vascular injury
分类号:
R713
文献标志码:
A
摘要:
目的探讨妇科腹腔镜手术中发生血管损伤的原因、处理及预防. 方法回顾分析我院1994年7月～2004年6月6 416例全麻腹腔镜手术中发生血管损伤的临床资料,分析其相关因素. 结果 6 416例妇科腹腔镜手术中血管损伤13例,其中9例腹壁下血管损伤,3例大网膜血管损伤,2例髂血管损伤,发生率0.2%(13/6 416).9例由于腹壁套管针穿刺所致, 4例由于术中操作引起,包括1例腹壁下动脉损伤、1例大网膜血管损伤以及2例髂血管损伤.发生血管损伤的主要原因是盆、腹腔中、重度粘连,视野暴露困难,局部解剖不清.1例腹壁下动脉损伤、1例大网膜血管损伤行腹腔镜下成功止血,其余9例均中转开腹手术.无一例死亡. 结论腹腔镜手术中血管损伤可发生于操作中的任何阶段,与医生的手术经验明显相关,盆、腹腔粘连是血管损伤发生的危险因素.加强腹腔镜操作技能培训,提高穿刺技术是减少腹腔镜手术中血管损伤的关键.
Abstract:
Objective　To investigate the causes, treatment and prevention of vascular injuries during laparoscopic gynecologic surgery.　M ethods　Clinical records of6 416 cases ofgynecologic laparoscopy undergeneral anesthesia from July 1994 to June 2004 in this hospitalwere retrospectively reviewed. Cases of blood vessel injuries were further analyzed.　Results　Vascular injuries happened in 13 cases, involving the inferior epigastric blood vessels (9 cases), the greateromentum blood vessels (3 cases), and iliac blood vessels (2 cases), respectively, with an incidence of0·2% (13/6 416). Injurieswere caused by trocar introduction in 9 cases and by intraoperative performance in 4 cases ( including 1 case of injuries of the inferior epigastric artery, 1 case of injuries of the greater omentum blood vessels, and 2 cases of injuries of the iliac blood vessels). Main causes accounting for the injuries were moderate-to-severe pelvic or abdominal adhesion, difficulties in the exposure of the surgical field, and inaccurate local anatomies. Bleedingwas successfully stopped under laparoscope in 1 case of injuries of the inferior epigastric artery and 1 case of injuries of the greater omentum blood vessels, while a conversion to open surgery was required in the remaining 9 cases. No death occurred.　 Conclusions　Vascular injuriesmay take place at any stages during a laparoscopic surgery and apparently correlated with surgeon’s experience. Pelvic or abdominal adhesion is an importantcause leading to the vascular injuries. For the prevention of the injuries, it is crucial to intensify the training of laparoscopic techniques.

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更新日期/Last Update: 2014-03-11