腹腔镜手术治疗肝脓肿的临床研究.DOC

腹腔镜手术治疗肝脓肿临床分析 田小林1 王海鹏1 朱小宝1 余双福2 丘继海3 （1，桂林医学院附属医院普外一科， 541001；2，广西阳朔县富康医院外科，541900；3，广西荔浦县中医院外科，546600） 摘要： 目的 总结腹腔镜手术治疗肝脓肿的方法及临床应用价值。 方法 采用腹腔镜手术治疗肝脓肿，分别使用脓肿穿刺、切开、开窗、吸引、冲洗、引流及膈下引流6种术式 ，总结治疗效果。结果 35例全部治愈出院, 术后住院7-16d，平均8.5d。术后并发胆瘘1例，门诊换药2月愈合；脐部感染1例，住院期间治愈。余术后均恢复顺利，腹痛、腹胀、发热于术后1-5d缓解，外周血白细胞4-7d均降至正常。结论 腹腔镜手术治疗肝脓肿，手术精确、简单、微创、可采用多种术式，效果好，是治疗肝脓肿的理想方法。 关键词 腹腔镜手术； 治疗； 肝脓肿 The clinical analysis of treating the liver abscess by using Laparoscopic surgery TIAN Xiao-lin WANG Hai-peng ZHU Xiao-bao YU Shuang-fu QIU Ji-hai (Department 1 of General Surgury, the Affiliated hospital of Guilin Medical College,541001. Department of Surgury, the FuKang hospital in Guangxi Yangshuo County, 541900. Department of Surgury,the traditional Chinese medical hospital in Guangxi Lipu County, 546600.) Abstract: Objective To summarize the method and the clinical practice value of Laparoscopic surgery in the treatment of the liver abscess. Methods Using the Laparoscopic surgery to treat the liver abscess in 6 technique types, including the abscess puncturation , the incision, the windowimg, the attraction, the flushing, the drainage and the subdiaphragmatic drainage, and summarizing the treatment result. Results 35 cases were cured and discharged from hospital completely. Of the 35 patients, the hospital stay after operation was 7-14 d (mean, 8.5 d).A biliary fistula happened after operation and was cured after 2 month change dressings in out-patient clinic, umbilical part infection happened in a case and was cured in hospital. The resume recovered successfully after operation, abdominal pain, abdominal distention and fever were relieved in 1-5d after operation, peripheral white blood cells dropped to normal in 4-7d after operation in all cases. Conclusion The surgery using Laparoscopic surgery to treat the liver abscess is precise, simple, micro creates, and may be able to use many kinds of technique type with excellent effect. It is the ideal method to treat the liver abscess. Key