简介:目的探讨宫腔镜腹腔镜联合检查与手术的适应证和优点。方法回顾性分析妇科29例应用宫、腹腔镜联合检查与手术的病例。结果检查结果与术前诊断符合18例(62.1%),不符合或有新发现11例(37.9%)。20例不孕症患者,发现子宫内膜异位病灶9例(45%);18例行输卵管美蓝通液术。腹腔镜监视下子宫纵隔电切割术6例及子宫粘膜下肌瘤剜出术2例。29例术后恢复良好,均未出现并发症。结论宫、腹腔镜联合检查与手术适用于怀疑宫腔、腹腔同时存在病变的病例;对于子宫穿孔可能性较大的宫腔镜手术,应采用腹腔镜监视;在不孕症的检查与治疗中具有重要价值。
简介:摘要目的探究腹腔镜胆囊切除术患者进行术前超声检查的应用意义。方法采取自愿原则在我院2015年2月至2016年2月期间所收治的腹腔镜胆囊切除术患者中选取36例参与本次探究,给予所有患者术前超声检查并记录患者胆囊大小、胆囊内结石情况、胆囊内息肉情况、壁厚度,仔细观察患者颈管部位是否存在结石嵌顿、胆囊周围是否存在粘连,胆囊窝内是否存在积液等,并将其与病理手术结果进行对比。结果本次探究中36例患者的的超声诊断结果以及病理手术结果符合率是91.66%。结论腹腔镜胆囊切除术患者进行术前超声检查的应用意义较为重要,可显著提升患者诊断符合率,值得在临床上应用推广。
简介:摘要目的探讨腹腔镜联合腹腔液糖类抗原CA125诊断子宫内膜异位症的临床应用价值。方法所有患者均采用气管内插管全身麻醉下行电视腹腔镜手术。术前吸出腹腔液(盆腔最低处)查糖类抗原CA125及细胞学检查,全面探查盆腔情况,根据(AFS)〔1〕评分标准在腹腔镜下进行分期后,行盆腔粘连松解术、电灼术,囊肿剥除术等,结合CA125检查结果,给以抗子宫内膜异位症药物治疗。结果21例子宫内膜异位症患者,其中Ⅰ期5例,Ⅱ期14例,Ⅲ期3例,分别行粘连分解术,电烧术,卵巢子宫内膜异位症囊肿剥除术,及导丝疏通术,恢复了盆腔子宫、输卵管、卵巢解剖功能,回访3—6个月,经期疼痛得到了改善,也增加了成功受孕机会。结论应用腹腔镜技术联合糖类抗原CA125诊断子宫内膜异位症,指导临床治疗,效果是肯定的,镜下盆腔解剖功能的恢复,有利于生活质量的提高和妊娠几率的提高。
简介:摘要目的比较机器人辅助腹腔镜下输尿管再植术(robot-assisted laparoscopic ureteral reimplantation,RALUR)与传统腹腔镜下输尿管再植术(laparoscopic ureteral reimplantation,LUR)在治疗婴幼儿原发性梗阻性巨输尿管(primary obstructive megaureter,POM)的应用效果。方法收集2020年1月至2021年4月应用RALUR和LUR治疗POM的18例患儿资料。其中,男11例,女7例;手术年龄范围为0~36个月。将接受RALUR的10例患儿作为RALUR组,中位年龄为9个月,年龄范围为4~35个月;患侧为左侧6例,右侧4例。将接受LUR的8例患儿作为LUR组,中位年龄为10个月,年龄范围为5~25个月;患侧为左侧6例,右侧2例。结果所有手术均顺利完成,无中转开放。RALUR组的手术时间为(149.0±18.9)min,LUR组为(194.4±45.0)min,差异具有统计学意义(P=0.01);RALUR组住院费用为(73 807.0±7 342.2)元,LUR组为(23 126.7±4 497.1)元,差异具有统计学意义(P<0.001);RALUR组的术后拔引流管时间为(4.2±1.7)d,LUR组为(4.8±2.5)d,差异无统计学意义(P=0.59);RALUR组的术后住院时间为(9.0±2.5)d,LUR组为(9.6±1.6)d,差异无统计学意义(P=0.54)。18例患儿术后随访时间范围为3~19个月,RALUR组及LUR组各有2例因尿路感染行抗感染治疗,术后3个月复查排泄性膀胱造影均未见明显反流,术后均无需再次住院治疗的短期并发症发生。结论运用RALUR和LUR治疗婴幼儿POM均安全、有效且恢复迅速。RALUR的手术时间更短,是一种可行的手术选择。
简介: 【摘 要】目的:探究腹腔镜联合消化内镜治疗胃肠道肿瘤与单纯腹腔镜的治疗效果。方法:于 2018年 4月~ 2020年 4月期间,随机抽取在我院接受治疗的 120例胃肠道肿瘤患者作为观察对象,对患者进行分组处理,入院号单号者为观察组( 60例),采取腹腔镜联合消化内镜治疗;入院号双号者为对照组( 60例),采取单纯腹腔镜治疗。分别观察两组患者的治疗效果、手术情况以及患者治疗后的不良反应发生情况。结果:观察组患者的治疗总有效率为 96.7%,显著高于对照组的 80.0%,两组比较具有统计学意义( =8.0863; P<0.05);观察组患者手术时间和住院时间更短、术中出血量也更少,各指标进行比较的差异具有统计学意义( P<0.05);同时,观察组患者中,出现恶心、腹痛等不良反应的有 3例,占 5.0%,对照组中有 18例患者出现了上述不良反应,两组患者的不良反应发生率比较具有统计学意义( =12.9870; P<0.05)。结论:腹腔镜联合消化内镜治疗胃肠道肿瘤的效果较好,治疗的有效率高,随访观察中患者出现不良反应的发生率也较低,治疗的有效性和安全性高,手术进展的情况也更加顺利,缩短了手术时间和住院时间,临床应用的安全性和可行性高,值得进行推广。 【关键词】腹腔镜;消化内镜;胃肠道肿瘤;治疗效果 [Abstract] Objective: To explore the effect of laparoscopy combined with digestive endoscopy in the treatment of gastrointestinal tumors and laparoscopy alone. Methods: from April 2018 to April 2020, 120 cases of gastrointestinal cancer patients in our hospital were randomly selected as the observation objects, and the patients were divided into two groups: the observation group (60 cases) with admission number and odd number was treated by laparoscopy combined with digestive endoscopy; the patients with double admission number were the control group (60 cases), and were treated with simple laparoscopy. The treatment effect, operation and adverse reactions of the two groups were observed respectively. Results: the total effective rate of the observation group was 96.7%, which was significantly higher than 80.0% of the control group, the comparison between the two groups was statistically significant (= 8.0863; P < 0.05); the operation time and hospitalization time of the observation group were shorter, and the intraoperative blood loss was also less, the difference of each index was statistically significant (P < 0.05); at the same time, in the observation group, nausea, abdominal pain, etc There were 3 cases of good reaction, accounting for 5.0%, 18 cases of patients in the control group had the above adverse reactions, the incidence of adverse reactions between the two groups was statistically significant (= 12.9870; P < 0.05). Conclusion: the effect of laparoscopy combined with digestive endoscopy in the treatment of gastrointestinal cancer is good, the effective rate of treatment is high, the incidence of adverse reactions in patients with follow-up observation is also low, the treatment is effective and safe, the operation progress is more smooth, shorten the operation time and hospital stay, the clinical application of safety and feasibility is high, it is worth promoting.
简介:摘要目的分析妇科腹腔镜检查中发生输尿管损伤的原因,诊疗和预防对策。方法回顾性分析我院妇科腹腔镜检查中发生输尿管损伤患者的临床资料。结果在618例妇科腹腔镜检查中,输尿管损伤发生率是0.81%;发生输尿管损伤的5例病人均有盆腔粘连,患有子宫肌瘤2例,子宫内膜异位症2例,宫颈肌瘤1例,子宫腺肌症1例;3例进行腹腔镜辅助阴式子宫切除术(LAVH),2例进行腹腔镜下全子宫切除术(TLH);输尿管损伤部位膀胱入口处3例,子宫动脉下靠近宫颈内口外侧2例;损伤症状包括发热,恶心呕吐,腹胀或腹痛,引流量增多等;确诊方法主要采用静脉肾盂造影和B超;治疗以手术为主,预后均较好。结论妇科腹腔镜检查过程中输尿管损伤的发生率较低,主要发生在腹腔镜下子宫切除手术中,术者医生应密切观察患者手术前后的临床表现,创造良好的手术环境,高度警惕发生输尿管损伤。