妇科手术的并发症
- Author
- William J Mann, Jr, MD
William J Mann, Jr, MD
- Section Editor — Gynecologic Surgery
- Clinical Professor
- Department of Obstetrics and Gynecology
- Virginia Commonwealth University School of Medicine
- Section Editor
- Howard T Sharp, MD
Howard T Sharp, MD
- Section Editor — Gynecologic Surgery
- Professor and Vice Chair for Clinical Activities
- Department of Obstetrics and Gynecology
- University of Utah Health Sciences Center
- Deputy Editor
- Sandy J Falk, MD, FACOG
Sandy J Falk, MD, FACOG
- Director, Editorial Relations — UpToDate
- Deputy Editor — Obstetrics, Gynecology and Women's Health
- Instructor of Obstetrics, Gynecology and Reproductive Biology, Part-time
- Harvard Medical School
- Translators
- 汤萍萍, 主治医师
汤萍萍, 主治医师
- 北京协和医院妇产科
引言
妇科大手术往往需要在膀胱、直肠、输尿管和盆腔大血管附近进行精细分离。妇科手术的并发症包括出血、感染、血栓栓塞和脏器损伤。并发症发生的风险取决于手术的范围、手术方式及患者特点。可以理解，这类手术更常见的并发症与这些脏器损伤有关，发生于肿瘤治疗的广泛性切除术时或因感染或子宫内膜异位症而使解剖异常时。其他并发症，如肺栓塞、心肌梗死、肺炎、体液或电解质失衡，在所有手术中均常见。(详见各自相关主题章节)。
出血
妇科手术中的出血将单独详细讨论。 (参见“妇科手术出血的处理”)
子宫穿孔
子宫穿孔是所有宫内操作均可能发生的并发症，可能与周围血管或脏器(膀胱、肠)的损伤有关。此外，在操作时未诊断的子宫穿孔及相关并发症会导致出血或脓毒症。使进入宫腔困难(如宫颈狭窄)或改变子宫肌层壁强度(如妊娠、绝经)的因素会使子宫穿孔的风险增加。
子宫穿孔将单独讨论。 (参见“妇科操作中的子宫穿孔”)
泌尿道损伤
根据不同的手术指征和操作方式，输尿管和膀胱损伤的发生率各不相同。泌尿道损伤的危险因素包括：恶性疾病手术、尿失禁或盆腔脏器脱垂的手术。
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