急诊腹腔镜在外科急腹症中临床应用.docVIP

急诊腹腔镜在外科急腹症中临床应用【摘要】 目的 探讨急腹症患者行急诊腹腔镜检查和治疗的临床应用价值。方法 回顾分析我院2004年10月至2009年12月收治的行急诊腹腔镜探查及手术治疗的206例外科急腹症患者的临床资料。结果 所有患者于入院后早期急诊行腹腔镜探查均获得明确诊断,全部行腹腔镜手术治疗,无中转开腹病例,全组均获痊愈,术后平均住院天数7 d。结论 腹腔镜诊治外科急腹症准确、安全,既可明确诊断又能同时进行治疗,对于入院诊断不明确的患者,急诊腹腔镜具有早期诊治,减轻痛苦,缩短住院时间等优点。 ? 【关键词】 外科急腹症;腹腔镜术;诊断;治疗;早期手术 Clinical application of emergency laparoscopy in surgical acute abdomen LIU Hui, YE Xiao-han, Gao hong-jun, et al. The Sixth People′s Hospital of Luohe City,Luohe 462000,China? 【Abstract】 Objective To investigate the value of applying the emergency laparoscopy in the diagnosis and treatment on the patients with the surgical acute abdomen. Methods The clinical data of emergency explorations and treatments in 206 patients with surgical acute abdomen were reviewed retrospectively,from Oct. 2004 to Dec. 2009.Results Emergency laparoscopyic operation for the detection was early taken and diagnosis was clarified laparoscopyically in all patients. Operation were completed under laparoscopy in all patients. None converted to open surgery. All cases are cured. The mean hospital stay after operation were 7 days. Conclusion Laparoscopy in the diagnosis and treatment of surgical acute abdomen is accurate and safe, and cannot only diagnose the acute abdomen definitely,but also treat it when it is necesserary. Especially hard to diagnosis, the emergency laparoscopy operation have the advantages of earlier diagnosis, lighter pain and shorter hospitalization to the patients with the surgical acute abdomen.? 【Key words】 Surgical acute abdomen;Laparoscopy;Diagnosis;Treatment;Early operation 作者单位:462000漯河市第六人民医院 随着腔镜技术的不断提高和设备器械的完善,腹腔镜已广泛应用于腹部外科领域,同样也包括急腹症的诊断和治疗。特别对于诊断不明确的急腹症,腹腔镜探查取代盲目开放性剖腹探查,显示了其巨大的优越性,不但能达到微创的目的,而且能避免过分积极剖腹探查所增加的阴性探查率[1]。我院2004年10月至2009年12月间为收住的206例外科急腹症患者行急诊腹腔镜探查及手术治疗,效果良好,现报告如下。 1 资料与方法 1.1 临床资料 本组206例中,男92例,女114例,16～83岁,平均52岁。急性阑尾炎62例,急性结石嵌顿性胆囊炎124例,急性化脓性胆管炎2例,十二指肠球部溃疡穿孔6例,粘连性不全性肠梗阻5例, Meckel 憩室炎2例,大网膜血管脂肪瘤蒂扭转1例,结核性腹膜炎2例,急性化脓性盆腔炎2例。 1.2 手术方法 所有患者均于住院后6 h内,在