RESUMEN
Objective To explore the feasibility and safety of laparoscopic resection of large uterus . Methods We performed laparoscopic hysterectomy in patients who had more than 3 months pregnant huge uterus in our hospital from January 2010 to December 2013.The mirror trocar was introduced at 5 cm above fundus .Surgical key steps were appropriate management of uterine blood vessels, electrical coagulation of the ascending uterine artery , and dissection of uterine vessels from front , rear, and lateral sides. Results The laparoscopic surgery was completed in all the 200 cases, without conversion to laparotomy .The operation time was 80-170 min,with a mean of 120 min;the blood loss was 20-250 ml,with a mean of 60 ml.No blood transfusion was required due to hemorrhage during operation .Two cases developed deep vein thrombosis at the third day after surgery , and were cured by anticoagulant therapy .Two patients with vaginal stump inflammation at 15 postoperative day were cured by applying the metronidazole powder at vaginal .One patient were sutured by 2 stitches for vaginal stump bleeding at the first month after the operation .The remaining patients had no serious complications .Postoperative hospital stay was (5 ±2) days.Follow-up reviews in 144 patients for 6 months found satisfactory heal of the vaginal stump , normal ultrasonographic results of bilateral ureters , and no abnormity in the pelvic cavity. Conclusion Laparoscopic hysterectomy of large uterus with bipolar coagulation is safe and feasible .
RESUMEN
ObjectiveTo observe influence of psychological nursing on perioperative irritated response of patients undergoing gynecological surgeries. MethodsOne hundred and twenty gynecological surgical pa-tients were randomly divided into the psychological nursing group and the control group, each group included 60 cases. Patients in the control group were given routine nursing. In addition of routine nursing, patients in the psychological nursing group were given perioperative psychological nursing intervention. The change of psycho-logical reaction, heart rate and blood pressure of the two groups were compared. ResultsCompared with the control group, number of patients with 3 to 4 grade of anxiety and terror in the psychological nursing group was significantly lower. Compared with that of preoperative day, heart rate and blood pressure in the control group evidently increased 5 minutes after entering the operation room, while in the psychological nursing group, except heart rate increasing, blood pressure was more stable. ConclusionsPsychological nursing can alleviate anxi-ety of patients undergoing gynecological surgeries, maintain normal hemodynamics and promote early recovery of patients.