摘要
目的:探讨泌尿外科腹腔镜手术中下腔静脉被Hem-o-lok结扎锁误夹后的处理方法及预防措施。方法:回顾分析3例腹腔镜手术中下腔静脉被误夹患者的临床资料,1例腹腔镜下肾癌根治,1例肾上腺嗜铬细胞瘤切除,1例结石并积脓肾切除,3例手术过程中部分下腔静脉均被Hem-o-lok结扎锁误夹。发现夹闭后,立即暂停手术,评估下腔静脉损伤情况。最后用超声刀打开Hem-o-lok,吸净积血、增加气压,用4-0血管缝线"8"字缝合破口。结果:2例被Hem-o-lok损伤的下腔静脉于镜下成功修补,分别耗时720 s、840 s;出血25 ml、40 ml。1例局部覆盖止血纱布保守治疗。术后患者恢复良好,未发生相关并发症。结论:腹腔镜下被Hem-o-lok结扎锁误夹的下腔静脉,常常破口较小,出血少易控制,可尝试腹腔镜下打开Hem-o-lok结扎锁,修补破口。对于夹闭下腔静脉较少的患者可保守治疗方式。
Objective：To study the treatment and prevention for inferior vena cava mistakenly clipped by Hem-o-lok during urology laparoscopic surgery. Methods：Clinical data of 3 cases of inferior vena cava mistakenly clipped by Hem-o-lok during laparoscopic surgery were retrospectively analyzed. One case of laparoscopic radical nephrectomy,one case of adrenal pheochromocytoma resection,one case of calculi and empyema renal resectionwhich;the three cases were all mistakenly clipped. After being clipped,the operation was immediately suspended and the damage was checked;effective measures were taken to keep the visual field clear. Finally ultrasonic knife was used to open the Hem-o-lok;the injured vena cava was sutured by 4-0 blood vessel suture line. Results：Two cases were repaired successfully by laparoscopy,respectively using 720 seconds and 840 seconds as well as 25 ml and 40 ml blood. One case treated with topical hemostatic gauze. All patients recovered with no complication being observed. Conclusion：Inferior vena cava mistakenly clipped by Hem-o-lok often has small rap,less bleeding,and no complication.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2016年第2期214-216,共3页
Journal of Chongqing Medical University
基金
广西桂林市科学研究与技术开发项目(编号:20120121-1-2)
关键词
腹腔镜手术
手术中并发症
腔静脉
下
泌尿系疾病
laparoscopy
intraoperative complications
vena cava
inferior
urologic diseases
