腹腔镜在急性全腹膜炎中的临床应用

目的探讨腹腔镜在急性全腹膜炎的临床应用价值。方法总结2002年1月～2012年9月我院共收治的经腹腔镜手术146例外科急腹症病例的治疗经验。结果本组146例急性全腹膜炎患者．经腹腔镜探查明确诊断，其中术前诊断与术中所见不吻合11例，135例诊断符合，139例腹腔镜下顺利完成手术，7例中转开腹手术，经治愈或好转顺利恢复出院，无死亡病例。结论腹腔镜探查急性腹膜炎，具有探查范围广、创伤小、恢复快，较多病例可以腹腔镜下直接完成，对术前无法明确的腹膜炎，既可明确诊断又能同时治疗，避免了剖腹探查的肓目性．具有较好的临床应用价值。

Laparoscopy in acute general peritonitis clinical application

Objective To explore the laparoscopy in acute general peritonitis clinical application. Methods From 2002 January to 2012 September were treated in our hospital surgical acute abdomen eases, laparoscopie operation in 146 cases, including 99 cases of acute appendicitis complicated perforation, 22 cases of perforation of gastroduodenal ulcer, caused by abdominal blunt trauma in jejunum and ileum perforation 14 cases, acute cholecystitis with perforation 9 cases, ruptured hepatocellular carcinoma 1 cases, splenic rupture caused by closed abdominal injury repair in 1 cases. Results All of the 146 cases were diagnosed after laparoscopic exploration, in which the upper digestive tract perfora- tion in 67 cases （39 patients with perforation of gastric ulcer and duodenal ulcer perforation： a report of 28 cases）, a- cute suppurative appendicitis （with or without perforation） in 32 cases, 22 cases of acute pelvic inflammatory disease, intestinal perforation in 12 cases, 5 cases of fallopian tube empyema, Meckel＇s diverticulum complicated with perfora- tion 3 cases, gastric perforation 3 cases, colon perforation in 2 cases. 53 cases of direct laparoscopie operation, the re- maining patients recovered successfully healed after dressing change. Conclusion Emergency laparoscopy acute peri- tonitis wide exploration, less trauma, quicker recovery, can guide the open operation treatment.