摘要目的探讨超声手术刀在妇科腹腔镜手术中的应用价值。方法在腹腔镜下应用超声手术刀进行各种妇科手术，观察术中失血量、手术时间、围手术期体温和血象变化以及组织的损伤程度。结果在腹腔镜下使用超声手术刀进行各种手术42例。其中子宫切除术4例，卵巢囊肿剥出或切除术9例，输卵管切除术18例，输卵管切开取胚术4例，子宫肌瘤挖出术3例，单纯粘连分离术3例，附件切除术1例。术中失血量、手术时间以及对组织的损伤程度与手术类型有关，最少失血量、手术时间、组织的损伤深度、损伤平分以及纤维蛋白沉积平分平均分别为24.77±4.71 毫升、23.39 ±3.01分钟、0.22±0.10毫米、0.98±0.21和0.38±0.26，最大失血量、手术时间、组织的损伤深度、损伤平分以及纤维蛋白沉积平分平均分别为166.7±47.18 毫升、127.2±16.99分钟、0.35±0.20毫米、1.25±0.20和0.81±0.29。除子宫切除术以外，其它各种手术在手术前后体温、血红蛋白以及白细胞总数之比较差异无显著性。结论超声手术刀在妇科腹腔镜下进行各种妇科手术，由于操作简单，安全可靠的，因而值得推广。

abstractsObjective To investigate the applied value of the ultrasonic scalpel in gynecologic operative laparoscopy. Methods Gynecologic operations were performed using the ultrasonic scalpel under laparoscopy. Operative bleeding and time, perioperative body temperature and hemogram, and tissue damage were observed.Results Forty-two cases of benign gynecologic diseases were treated with the ultrasonic scalpel under laparoscopy. Among them, there were 4 hysterectomies, 9 ovarian cystectomies, 18 salpingotomies, 4 ectopic pregnancies, 3 myomectomies, 3 adhesiolysis and 1 adnexectomy. The amount of operative bleeding, operating time and the tissue injury were related to the type of operation. The minimual operative bleeding amount, operating time, depth of tissue necrosis, tissue injury score and fibrin deposition score were 24.77±4.71ml, 23.39±3.01 min, 0.22±0.10mm, 0.98±0.21 and 0.38±0.26, respectively. The maximal operative bleeding amount, operating time, depth of tissue necrosis, tissue injury score and fibrin deposition score were 166.7±47.18ml, 127.2±16.99 min, 0.35±0.20mm, 1.25±0.20 and 0.81±0.29, respectively. The levels of body temperature, white blood cells and hemoglobin before and after the operations were not statistically different (P>0.05) except for hysterectomy (P<0.05). Conclusion The ultrasonic scalpel can be safely applied for gynecologic operative laparoscopy and should be used widely.