腹腔镜在普外科急腹症诊断和治疗中的应用

目的:探讨腹腔镜技术在普外科急腹症诊断治疗中的应用效果和优势。方法:回顾性分析2010年6月-2012年4月本科收治的46例采用腹腔镜技术诊断和治疗的急腹症患者的临床资料。结果:46例急腹症患者经探查:良性十二指肠球部溃疡及胃溃疡穿孔4例、胆囊结石13例、急性胆囊炎6例、胆囊扭转1例、重症急性胰腺炎1例、肠梗阻4例、急性阑尾炎7例,闭合性腹部损伤2例、宫外孕4例、急性盆腔炎2例、原发性腹膜炎2例。46例患者在术中全部明确诊断,确诊率达到100%。行腹腔镜微创手术治疗44例,占95.6%;中转开腹2例,占4.4%。术后住院时间为(6.37±1.09)d,术中术后均无并发症出现,全部治愈出院。结论:腹腔镜技术确诊率高、安全性和疗效显著、术后恢复快,在普外科急腹症诊断和治疗中的临床效果和优势明显。

The Application of Laparoscopy in the Diagnosis and Treatment of Acute Abdomen in General Surgery

Objective ：To explore the effects and advantages of application of laparoscopic technique in the diagnosis and treatment of generalsurgical acute abdomen.Method：Retrospective analyze 46 cases of acute abdomen with laparoscopic diagnosis and treatment,the patients were curedfrom June 2010 to April 2012 in our hospital.Result：46 cases with acute abdomen：4 cases of benign duodenal ulcer and gastric ulcer perforation,13cases of gallbladder lithiasis,6 cases of acute cholecystitis,1 case of gallbladder torsion,1 case of severe acute pancreatitis,4 cases of intestinalobstruction,7 cases of acute appendicitis,2 cases of closed abdominal injury,4 cases of ectopic pregnancy,2 cases of acute pelvic inflammatorydisease,2 cases of primary peritonitis.46 patients were clarified a diagnosis during surgery,the rate of diagnosis was 100%,44 cases of laparoscopicminimally invasive surgery,accounting for 95.6%;2 cases were converted to laparotomy,accounting for 4.4%.Postoperative hospital stay was（6.37±1.09）days,there was no complications in intraoperative and postoperative time.All patients were healed when leaved the hospital.Conclusion：The laparoscopictechniques has high diagnosis rate,significant safety and efficacy,rapid postoperative recovery,obvious clinical effect and advantage in the diagnosisand treatment of general surgical acute abdomen.