对女性生殖器结核病例中的腹腔镜并发症和困难的比较研究与非结核病例
Jai Bhagwan Sharma1, Sona Dharmendra1, Gawri Rapaka1
1Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India.
Journal of minimal access surgery
|June 26, 2023
概括
与非FGTB病例相比,女性生殖器结核病 (FGTB) 病例中的腹腔镜检查存在重大困难和并发症,包括较高的出血率,器官损伤和伤口感染. 这些发现凸显了FGTB患者手术相关的风险增加.
科学领域:
- 生殖医学 生殖医学
- 传染性疾病 传染性疾病
- 手术瘤学手术瘤学
背景情况:
- 女性生殖器结核病 (FGTB) 是导致不孕症的重要原因,特别是在发展中国家.
- 在FGTB病例中,诊断性腹腔镜检查可能具有挑战性,并带有风险.
- 这项研究旨在评估FGTB患者在腹腔镜检查期间遇到的具体困难和并发症.
研究的目的:
- 评估FGTB患者腹腔镜检查过程中的手术挑战.
- 在FGTB中识别和量化与腹腔镜相关的并发症.
- 为了将这些发现与接受其他指示腹腔镜检查的对照组进行比较.
主要方法:
- 一项前性研究涉及412名患有不孕症和疑似FGTB的妇女,接受了诊断性腹腔镜检查.
- 患者接受了临床检查,子宫内膜采样 (AFB显微镜,培养,PCR,基因Xpert) 和组织病理学.
- 作为对照,412名没有FGTB的女性的对照组也接受了腹腔镜检查.
主要成果:
- 在所有病例中都诊断出确定的或可能的FGTB (41.50%确定的,58.49%可能).
- 在FGTB病例中的腹腔镜检查显示,肺上皮膜创建 (16.74% vs 1.94%),三角管插入 (13.10% vs 1.69%),过度出血 (5.09% vs 0.97%),肠道损伤 (1.69% vs 0.24%),膀损伤 (0.97% vs 0.24%),亚急性肠道阻塞 (5.8% vs 0.72%) 和伤口感染 (8.48% vs 1.25%) 的难度明显更高.
- 在5.09%的FGTB病例中观察到结核病发作,对照组没有发生这种情况.
结论:
- 女性生殖器结核病与诊断性腹腔镜检查期间的困难和并发症大幅增加有关.
- 这些发现强调了腹腔镜在FGTB中的危险性,需要仔细考虑和管理策略.
- 加强警和专业技术可能需要在FGTB患者中进行更安全的腹腔镜手术.
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