协和医学杂志

2019, v.10(04) 322-325

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妇科腹腔镜术中肠管损伤问题
Intestinal Injury in Gynecological Laparoscopic Surgery

陈倩;樊庆泊;
CHEN Qian;FAN Qing-bo;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

摘要(Abstract):

随着腔镜技术的发展,临床上越来越多的妇科手术在腔镜下进行。肠管损伤是妇科腹腔镜手术并发症之一,因其发生率较低,部分患者术中难以发现,而延迟诊断可造成严重不良后果。肠管损伤可分为手术器械对肠管的机械损伤和热损伤两种。盆腹腔组织粘连是腹腔镜手术发生肠管损伤的主要危险因素,既往盆腹腔手术史、盆腹腔炎性疾病等均可导致组织粘连;此外,手术医师经验也会影响肠管损伤的发生几率。早期识别肠管损伤和正确及时的处理方式对于降低其发病率和死亡率至关重要,其中恢复肠壁解剖结构、避免肠漏是关键。
With the development of laparoscopic techniques,more and more gynecological operations are performed under the laparoscope. Intestinal injury is one of the complications of gynecological laparoscopic surgery with a relatively low incidence. Some of the cases are difficult to be identified during surgery,and a delayed diagnosis can bring about serious consequences. Intestinal injury can be divided into mechanical injury and thermal injury. Adhesions in the pelvic and abdominal cavity are the main risk factors for intestinal injury in laparoscopic surgery. Pelvic and abdominal surgery and inflammatory disease can lead to pelvic-abdominal tissue adhesion. The surgeon's experience also affects the incidence of intestinal injury. Early identification of intestinal injury,as well as proper and timely treatment is critical to reducing the morbidity and mortality. The key to treating an intestinal injury is to restore the anatomy of the intestinal wall and avoid the appearance of intestinal leakage.

关键词(KeyWords): 妇科,腹腔镜手术;肠管损伤;影响因素;诊断;处理
gynecology,laparoscopic surgery;intestinal injury;factor;diagnosis;treatment

Abstract:

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基金项目(Foundation): 国家科技支撑计划(2015BAI13B04);; 中国医学科学院医学与健康科技创新工程(2017-I2M-1-002)

作者(Author): 陈倩;樊庆泊;
CHEN Qian;FAN Qing-bo;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

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