急腹症微创诊治的临床分析

目的:探讨腹腔镜在急腹症诊疗中的临床应用价值。方法:选取2005-07-2010-06在我院普外科应用腹腔镜诊治急腹症的患者458例,其中男215例,女243例,平均年龄42.6岁。病因包括:阑尾炎247例,急性胆囊炎109例,腹痛待查12例,胃肠穿孔并腹膜炎30例,肠梗阻14例,肠肿瘤4例,腹部外伤23例,妇科疾病15例。结果:通过腹腔镜完成手术的患者426例(93.01%),426例患者经腹腔镜诊疗之后均全部治愈出院,手术时间30～200min,平均时间为59.90min;出血量10～400ml,平均出血105ml,所有患者在治疗过程中均未输血;住院时间为3～15d,平均住院时间6.2d。术后、出院检查及随访无并发症。结论:腹腔镜应用于选择的急腹症诊治过程中安全可行,对病因不明确的急腹症患者同时提供及时诊断治疗作用,减少误诊及并发症,对女性及肥胖患者优势更明显。

Clinical analysis of minimally invasive diagnosis and treatment of acute abdomen

Objective： To evaluate the clinical analysis of the laparoscopie technology on the diagnosis and treat- ment of acute abdomen. Method.. From July 2005 to June 2010, 458 acute abdomen patients admitted in the depart- ment of general surgery general application of laparoscopic diagnosis and treatment of acute abdominal pain pa- tients 426 example, male 215 cases, female 243 cases, with an average age of 42.6 years, etiology including acute appendicitis （247 cases）, acute cholecystitis （109 cases）, gastrointestinal perforation and peritonitis （30 cases）, intestinal obstruction （16 cases）, bowel tumor （4 cases）, abdominal trauma or a gunshot wound （23 cases）. Re- suit：Four hundred and twenty-six cases accepted laparoscopic operation （93.01%） without postoperative complications. The operation time was 30-200 minutes （average 59.9 minutes）, the blood loss was 10-400 ml （aver- age 105 ml）, hospital stay was 3-15 （average 6.2 days）. Conclusion： Laparoscopic technology showed advantages in the diagnosis and treatment of chosed acute abdomen, including minimal invasive, rapid recovery, less misdiag- nosis and complications especially to female or obese patients.