腹腔镜诊治急腹症临床分析

目的探讨腹腔镜对急腹症的诊断与治疗价值。方法对236例急腹症患者采用腹腔镜进行诊断与治疗,回顾性分析手术时间、术中出血量、术后下床活动时间、术后进食时间、术后住院天数、术后并发症及切口愈合情况等。结果术前确诊率为69.92%(165/236),腹腔镜手术确诊率为100%(236/236),后者显著高于前者。腹腔镜手术成功率为90.25%(213/236),手术时间为(45.1±8.3)min,术中出血量为(79.3±28.2)mL,术后下床活动时间为(21.2±4.7)h,进食时间为(1.8±0.6)d,住院天数为(5.8±1.9)d。切口愈合情况良好,无大出血及腹腔积液,未发生与腹腔镜手术相关的并发症及不良反应,无手术死亡病例。23例患者中转开腹手术,全部患者均痊愈出院。结论腹腔镜手术在急腹症的诊疗中具有诊断价值高、手术时间短、出血少、术后恢复快及并发症少等优点,临床可针对具体情况合理选择使用腹腔镜手术治疗急腹症。

Clinical analysis of laparoscopis diagnosis and treatment of acute abdomen patients

Objective Through the general surgery in patients with acute abdominal pain by laparoscopic surgery, analysis on the patients with acute abdominal pain of the clinical diagnosis and therapeutic value. Methods In January 2010 to January 2013, choose our general surgery patients with acute abdominal pain to the hospital of 236 cases of acute abdomen patients as the research object, the retrospective analysis of the laparoscopie surgery for clinical diagnosis and treatment of medical records in hospital. Summary analysis operation time, intraoperarive and postoperative bleeding can bed activity time, postoperative feeding time, postoperative hospitalization days, postoperative complications and wound healing. Results Laparoscopic surgery positive rate was 100% （236/236）, preoperative diagnosis rate was 69.92% （ 165/236 ）, the former is significantly higher than the latter （x2 = 27. 903, P 〈 0.01 ）. Laparoscopic surgery success rate was 90.25 % （213/236 ）, 23 patients transfer laparotomy. 213 cases of acute abdomen patients laparoseopic surgery time is （45.1 ± 8.3 ）min, during the operation, the amount of bleeding for （79.3 ±28.2 ） ml, under the bed activity time is （ 21.2 ± 4.7 ） h, eating time （ 1.8 ± 0.6 ） days, days in hospital for （ 5.8 ± 1.9） days after surgery, bleeding, bleeding and wound healing in good condition, no massive hemorrhage and abdominal cavity effusion, and did not produce and laparoscopic surgery related complications and adverse reaction, no operative deaths ,213 cases of acute abdomen patients were healed up and left hospital. Conclusion Minimally invasive laparoscopic surgery in the diagnosis and treatment of acute abdomen with di- agnostic value is high, the treatment of shorter operation time, less bleeding, rapid recovery and less postoperative complications, etc. , and clinical according to specific condition reasonable choose to use laparoseopic surgery treatment of acute abdomen.