腹腔镜诊治急慢性腹痛37例分析

目的 :探讨腹腔镜在诊断和治疗不明原因急慢性腹痛中的作用。方法 :回顾分析不明原因急慢性腹痛 37例的临床资料。结果 :急性腹痛 15例中 ,11例行腹腔镜治疗 ,2例未行外科处理 ,2例开腹手术。无误诊及漏诊。治疗患者术后腹痛均明显好转或治愈 ,有效率为 10 0 %。慢性腹痛 2 2例 ,镜下诊断 2 1例 ,其中 1例误诊。 12例行腹腔镜治疗 ,3例行开腹手术 ,6例未进一步手术治疗。 1例腹腔镜下未见异常。手术治疗者近期效果均良好 ,有效率为 93%(14 / 15 )。所有急慢性腹痛患者腹腔镜探查或治疗均无严重并发症。腹腔镜术后 3～ 6d出院。结论 :腹腔镜诊断急慢性腹痛准确率较高 ,腹腔镜治疗减少了患者痛苦 ,缩短了住院时间。腹腔镜应作为外科诊治不明原因急慢性腹痛患者的首选方法。

Laparoscopy in the diagnosis and treatment of acute and chronic abdominal pain:with an analysis of 37 cases

Objective:To explore the role of laparoscopy in the diagnosis and treatment of acute and chronic abdominal pain.Methods:The clinical data of 37 cases with acute and chronic abdominal pain of unknown origin were retrospectively analyzed.Results:15 patients with acute abdominal pain,were definitly diagnosed .11 cases received therapeutic laparoscopy,2 cases were performed laparotomy,and 2 cases received no surgical treatment.No misdiagnosis or missed diagnosis happened.All the patients were cured or felt better after surgical treatment,the utility rate is 100%.21 patients with chronic abdominal pain were diagnosed definitly,1 case was misdiagnosed.12 cases received therapeutic laparoscopy,3 cases received laparotomy,and 6 cases received no surgical treatment.1 case was found no abnormality.All the patients felt better after surgical treatment except the misdiagnosed one,the therapeutic utility rate was 93%(14/15).No severe complications occurred after laparoscopic exploration or therapeutic laparoscopy.By laparoscopic operation,patients left hospital within 3～6 days after operation.Conclusions:Diagnostic laparoscopy is high accurate in evaluating acute and chronic abdominal pain.Therapeutic laparoscopy is applicable and can be applied as the primary surgical intervention in patients with acute and chronic abdominal pain of unknown origin.