腹腔镜在非梗阻性急腹症中应用.docVIP

腹腔镜在非梗阻性急腹症中应用【摘要】 目的探讨腹腔镜在非梗阻性急腹症中的应用价值。方法 回顾分析 2005年4月至2008年10月40例非梗阻性急腹症患者行腹腔镜探查及诊治的临床资料。结果 15例未确诊的非梗阻性急腹症经腹腔镜明确诊断后在腔镜下进行了手术治疗13例,其中1例溃疡病穿孔中转开腹完成手术,急性胰腺炎转保守治疗痊愈。25例术前确诊急腹症,直接在腔镜下进行手术。15例术前未确诊的腔镜探查确诊率100%,40例腔镜下手术的中转率为5%。无术中和术后并发症发生,无死亡。本组38例得到随访,随访期2～24个月。结论 腹腔镜在非梗阻性急腹症中的应用具有损伤小、痛苦少、术后恢复快和安全有效、并发症少等优点,对提高急腹症诊断准确率、降低误诊率,使患者及时得到合理、有效的治疗有很大帮助。对于诊断困难的急腹症,采用腹腔镜下诊断或可以在腔镜下完成手术,采用腹腔镜诊治在基层医院可以推广应用。 ? 【关键词】 腹腔镜;急腹症;应用 【Abstract】 Objective To investigate the laparoscopy in nonobstructive acute abdomen in the application. Methods A retrospective analysis in April 2005 ~ October 2008 40 cases of nonobstructive acute abdomen in patients with laparoscopic exploration and treatment of clinical data. Results of 15 cases are not diagnosed nonobstructive acute abdomen diagnosed by laparoscopy carried out after endoscopic surgery in 13 cases, 1 case of ulcer perforation completion of interim abdominal surgery and conservative treatment of acute pancreatitis in turn healed. 25 cases of preoperative diagnosis of acute abdomen, directly in endoscopic surgery. 15 cases of preoperative diagnosis is not confirmed endoscopic detection rate of 100%, 40 cases of endoscopic surgery of the transit rate of 5%. No intraoperative and postoperative complications, and no death. This group 38 cases were followed up period of 2 to 24 months. Conclusion of laparoscopy in nonobstructive acute abdomen with a little injury, less pain, faster postoperative recovery and a safe and effective with few complications and so on. Improving the diagnostic accuracy of acute abdomen, reduce misdiagnosis rates, so that patients receive timely and reasonable and effective treatment of much help. Difficulties for diagnosis of acute abdomen, using laparoscopic diagnosis or can be completed in the endoscopic surgery, laparoscopic diagnosis and treatment the hospital can be applied at the grassroots level. 【Key words】 Laparoscopic;Abdomen;Apply 目前腹腔镜已广泛用于急腹症的诊断与治疗,特别是诊断不明确时,能避免不必要的阴性剖腹探查[1],但临床应用并不象腹腔镜胆囊切除那样,