腹腔镜诊治急腹症在基层医院中的应用体会

目的:探讨基层医院利用腹腔镜技术诊治急腹症的临床应用价值。方法:回顾分析2010年1月至2012年12月为204例急腹症患者行腹腔镜探查及治疗的临床资料。结果:患者均经腹腔镜探查获得确诊,其中急性阑尾炎86例,急性胆囊炎46例,急性上消化道穿孔30例,肠梗阻26例,卵巢黄体破裂6例,急性盆腔炎10例。186例于镜下完成治疗,18例中转开腹。其中83例行阑尾切除术,39例行胆囊切除术,30例行胃十二指肠溃疡穿孔修补术,11例行肠粘连松解术,7例行小肠部分切除术,6例行卵巢病灶切除术,10例盆腔炎行盆腔冲洗术。纠正术前诊断16例,14例发生手术并发症。平均住院(5.2±0.8)d。结论:腹腔镜技术可提高急腹症的确诊率,指导治疗,避免阴性探查,具有疗效确切、手术并发症少、术后康复快等优点,在基层医院中应用前景广阔。

hospital Application of laparoscopy in the diagnosis and treatment of acute abdomen in primary

Objective：To evaluate the value of laparoscopy in diagnosis and treatment of acute abdomen in the primary hospi- tal, Methods：A retrospective study was performed between Jan. 2010 and Dec. 2012. In this study, clinical data of 204 acute abdomen patients who were explored and treated with laparoscopy were retrospectively analyzed. Results：The diagnoses of all the patients were confirmed with laparoscopy,including 86 cases of acute appendicitis,46 cases of acute cholecystitis, 30 cases of acute upper digestive tract perforation ,intestinal obstruction in 26 cases ,6 cases with corpus luteum rupture, 10 cases of acute pelvic inflammatory disease. 186 cases underwent laparoscopy,which included 83 cases of appendectomy,39 cholecystectomy,30 repair of peptic ulcer perforation, 11 enterolysis ,7 partial intestinal resection ,6 ovarian lesion excision, and 10 abdominal drainage. 18 cases were Converted to laparoto- my. Wrong preoperative diagnosis was corrected in 16 cases. 14 cases suffered from operative complications. Mean hospital stay was （ 5.2 ± 0.8 ） d. Conclusions ： In primary hospitals,laparoseopy plays an important role in the correct diagnosis of acute abdomen, which could help clinical treatment and avoid issueless exploration. Because its good curative effect, low complication rate and quick postoperative recovery, the future of laparoscopy is bright in primary hospital.