腹腔镜治疗妇科急腹症的临床疗效

目的观察腹腔镜治疗妇科急腹症的临床疗效及其对高敏C反应蛋白（hs-CRP）和前白蛋白（PA）的影响。方法将2009年1月至2011年6月妇科急腹症的153例患者按照手术方式不同分为腹腔镜组（65例）和开腹组（88例）。观察两组患者手术时间、术中出血量、术后排气时间、疼痛分数（VAS）、住院时间、PA和hs-CRP的变化。结果治疗后,腹腔镜组的手术时间、术中出血量、肛门排气时间、疼痛分数、住院时间和并发症发生率均较开腹组短或者减少,两组比较差异有统计学意义（P〈0.01）。hs-CRP水平两组治疗后均较治疗前明显降低,但腹腔镜组较开腹组组降低更为明显（P〈0.01）。相反,PA水平均较治疗前明显提高,但腹腔镜组较开腹组提高更为明显（P〈0.01）。结论腹腔镜治疗妇科急腹症安全有效,术后恢复快,是妇科急腹症的主要手术方式。

Clinical observation of laparoscopic treatment in patients with gynecologic acute abdomen

Objective To evaluate the laparoscopic treatment on gynecologic acute abdomen and its impact on the levels of high-sensitive C-reactive protein （hs-CRP） and prealbumin （PA）. Methods According to the surgical methods, 153 cases of gynecologic acute abdomen from January 2009 to June 2011 were divided into laparoscopic group（65 cases） and laparotomy group （88 cases）. The operation time, blood loss, postoperative discharge time, pain scores（VAS）, hospital stay, PA and hs-CRP were determined. Results After treatment, the operation time, blood loss, anal exhaust time, pain scores,length of stay and complication rate were significantly reduced in the laparoscopic group than those in the laparotomy group（P0.01）.After the treatment,the levels of hs-CRP in the laparoscopic group were significantly decreased（P0.01）.In contrast,the PA levels in the laparoscopic group were significantly increased（P0.01）. Conclusion It is safe and effective to treat gynecologic acute abdomen with laparoscopy. Postoperative recovery was rapid and this method could be used as a major method in the treatment of gynecological acute abdomen.