腹腔镜手术在急慢性盆腔感染性疾病诊治中的应用

目的探讨腹腔镜手术在诊断和治疗急慢性盆腔感染性疾病(pelvic inflammatory disease,PID)中的应用价值.方法回顾分析我院1999年1月～2003年12月,我院83例PID腹腔镜诊断和处理的临床资料. 结果 2例慢性PID因盆腔严重粘连而中转开腹.无一例并发症.术前、术后诊断符合率为63.9%(53/83),其中急性PID组为74.3%(26/35),慢性PID组为56.2%(27/48).35例急性PID组手术时间20～75 min,平均44.7 min;术后住院3～12 d,平均6.2 d;术后病率28例,5 d内均恢复正常;术后2 d血常规恢复正常26例.48例慢性PID组手术时间20～130 min,平均75 min;术后住院2～8 d,平均5.5 d;术后病率5例,3 d内均恢复正常;术后2 d血常规恢复正常42例.全部病例均随访3个月,无一例复发. 结论及时腹腔镜手术有利于提高PID的确诊率,有利于PID的治疗和并发症的预防.

Application of laparoscopic operations for acute or chronic pelvic inflammatory diseases

Objective To investigate the value of laparoscopic operations for the diagnosis and treatment of acute or chronic pelvic inflammatory diseases (PID). Methods A series of 83 patients with PID diagnosed and treated by laparoscopic technique from January 1999 to December 2003 were retrospectively analyzed. Results Conversions to open surgery were required in 2 patients because of serious pelvic adhesions. No complications were observed. The diagnostic accordance rate before and after the surgery was 63.9% (53/83): 74.3% (26/35) in patients with acute PID and 56.2% (27/48) in patients with chronic PID. Among 35 patients with acute PID, the duration of operation was 20~75 min (mean, 44.7 min) and the postoperative hospital stay was 3~12 d (mean, 6.2 d). Postoperative pyrexia occurred in 28 patients, whose temperatures returned to normal within 5 days. The blood routine examination results were restored to normal levels in 26 patients at 2 days after operation. Out of 48 patients with chronic PID, the length of operation was 20~130 min (mean, 75 min) and the postoperative hospital stay, 2~8 d (mean, 5.5 d). Postoperative pyrexia occurred in 5 patients and a complete recovery of temperature was observed within 3 days. The blood routine examinations revealed normal findings in 42 patients at 2 days after operation. Follow-up checkups for 3 months in all the patients found no relapse. Conclusions Prompt application of laparoscopic operations is of importance in increasing diagnostic accuracy, improving curative efficacy, and preventing possible complications.