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目的:分析宫颈癌腹腔镜根治术致相关脏器损伤的原因,探讨减少和治疗相关脏器损伤的方法。方法:回顾性分析2010年1月至2016年1月在我院妇产科住院治疗的288例宫颈癌腹腔镜根治手术患者临床资料,统计肠道损伤、闭孔神经损伤、泌尿系脏器损伤及血管损伤的概率,分析可能原因,总结术中预防和术后治疗措施及经验。结果:在288例行宫颈癌腹腔镜根治术患者中,发生肠道损伤者10例,闭孔神经损伤者2例,泌尿系脏器损伤者22例,血管损伤术中、术后出血者5例,发生率分别为3.5%、0.6%、7.6%和1.7%。肠道损伤患者中,分别经术中及时缝合修补和二期手术治疗后痊愈,闭孔神经损伤术中及时修补术后预后好,泌尿系脏器损伤患者中,分别经手术吻合、留置输尿管支架及膀胱留置导尿治疗后痊愈,血管损伤患者中,分别经术中及时止血和二期手术止血治疗后痊愈。结论:宫颈癌腹腔镜根治术致脏器损伤与患者疾病本身及术者操作经验均有关,充分术前准备、规范的术中操作及术后密切观察,有助于减少脏器损伤及损伤后严重后果的发生,可提高临床疗效,改善患者预后。
Objective: To analyze the causes of laparoscopic radical mastectomy of cervical cancer and to discuss the methods to reduce and treat the damage of related organs. Methods: The clinical data of 288 cases of laparoscopic radical mastectomy for cervical cancer hospitalized from January 2010 to January 2016 in our hospital were retrospectively analyzed. The intestinal injury, obturator nerve injury and urinary organ injury And the probability of vascular injury, analyze the possible causes, summarize the intraoperative prevention and postoperative treatment measures and experience. Results: Of the 288 patients who underwent laparoscopic radical mastectomy for cervical cancer, there were 10 cases of intestinal injury, 2 cases of obturator nerve injury, 22 cases of organ injury in urinary system, 5 cases of vascular injury and 5 cases of postoperative bleeding Cases, the incidence rates were 3.5%, 0.6%, 7.6% and 1.7%. Intestinal injury patients, respectively, after suture and second surgery were cured, closed obturator nerve injury timely and good postoperative prognosis, urinary system injury patients, respectively, by surgical anastomosis, indwelling ureteral stent And bladder catheterization cure after hemorrhage, vascular injury patients, respectively, by the timely intraoperative and postoperative hemostasis hemostasis cured healed. Conclusion: The laparoscopic radical mastectomy for cervical cancer is related to the disease itself and to the operation experience of the surgeon. The adequate preoperative preparation, standardized intraoperative operation and close observation after operation help to reduce the organ damage and injury The occurrence of serious consequences can improve clinical efficacy and improve patient prognosis.