腹腔镜在妊娠期急腹症诊疗中的应用

目的 评价腹腔镜在妊娠期急腹症的临床诊疗价值. 方法 回顾分析1997年6月～2004年10月40例孕周在7～17周（平均13.2周）的妊娠期急腹症临床资料,其中宫内宫外妊娠16例,卵巢扭转3例,卵巢囊肿蒂扭转5例,急性胆囊炎5例,急性阑尾炎11例,应用腹腔镜诊断及治疗. 结果 40例均在腹腔镜下明确诊断,除1例宫内宫外妊娠盆腔粘连严重中转开腹外,余全部手术成功.手术时间25～70 min,平均38.2 min.术后皮下气肿1例.术后随访36例,先兆流产3例,难免流产3例,早产1例,足月分娩31例. 结论 腹腔镜手术治疗早、中期妊娠急腹症安全有效.

Application of laparoscopic techniques in the diagnosis and treatment of abdominal emergency during pregnancy

Objective To assess the value of laparoscopy in the diagnosis and treatment of abdominal emergency during pregnancy.Methods Clinical data of 40 cases of abdominal emergency at 7~17 gestational weeks(mean,13.2 weeks) from June 1997 to October 2004 were retrospectively reviewed.There were 16 cases of uterine with ectopic pregnancy,3 cases of twisted ovary,5 cases of pedicel torsion of ovarian cyst,5 cases of acute cholecystitis,and 11 cases of acute appendicitis.The diagnosis and treatment were conducted under laparoscope. Results The confirmative diagnosis was clarified under laparoscope in all the cases.Except 1 case of conversion to open surgery,the operation was accomplished laparoscopically in all cases. The operation time was 25~70 min(mean,38.2 min).Surgical complications occurred in 1 case.During postoperative follow-up observations,there were 3 cases of threatened abortion,3 cases of inevitable abortion,and 1 case of premature delivery. Conclusions Laparoscopic operation is safe and effective for acute abdominal emergency during early-to-middle pregnancy.