腹腔镜用于诊疗阑尾炎及消化道穿孔等急腹症临床观察.docVIP

腹腔镜用于诊疗阑尾炎及消化道穿孔等急腹症临床观察 　　[摘要] 目的 评价腹腔镜技术用于诊疗阑尾炎及消化道穿孔等急腹症的临床疗效及安全性。方法 回顾性分析不同时期的急腹症患者，分别采用腹腔镜手术及传统开腹式手术进行治疗，观察并对比分析腹腔镜下急腹症诊断的准确率及两组患者围手术期的相关指标、并发症的发生情况等，评价腹腔镜手术的临床疗效及安全性。结果329例行腹腔镜检查的患者均明确诊断，诊断准确率达100%；对于两组中急性阑尾炎、消化道穿孔患者而言，采用腹腔镜手术组的患者术中出血量、肠道功能恢复时间、住院时间较开腹组显著缩短（P0.05），同时术后肌注镇痛药物的患者例数较开腹组也显著减少（P0.05）；此外，腹腔镜组患者并发症发生率仅为3.34%，与开腹手术组患者相比显著降低，且差异具有统计学意义（χ2=18.015，P0.01）。 结论 腹腔镜技术对于胃肠外科急腹症诊治具有良好的疗效，安全可靠，值得在临床广泛应用。 　　[关键词] 胃肠外科；急腹症；腹腔镜 　　[中图分类号] R713[文献标识码] B[文章编号] 1673-9701（2014）16-0134-03 　　 　　Evaluation of efficacy and safety of laparoscopic techniques for acute abdomen such as appendicitis and gastrointestinal perforation 　　ZHANG Guixi1 HUANG Yongping2FAN Jingwen1 LIU Zhonghui1LIU Zhongmin2 　　1.Department of General Surgery，Shenzhen Hospital of Hongkong University， Shenzhen 518000，China； 2.Department of General Surgery，Longgang District Peoples Hospital of Shenzhen City, Shenzhen518172，China 　　[Abstract] Objective To evaluate the clinical efficacy and safety of laparoscopic technique for diagnosis and treatment of acute abdomen such as appendicitis and gastrointestinal perforation. Methods Patients with acute abdomen were selected， which were in different periods， and then received traditional open surgery and laparoscopic surgery respectively. The accuracy of acute abdomen diagnosis with laparoscopic， perioperative related indicators and the occurrence of complications were observed and analyzed comparatively， to evaluate the clinical efficacy and safety of laparoscopic technique. Results A definitive diagnosis was accomplished in 329 cases， the diagnostic accuracy rate which underwent laparoscopic examination reached 100%. For the patients with acute appendicitis and gastrointestinal perforation， the blood loss， intestinal function recovery time， hospital stay in patients with laparoscopic surgery group were significantly shorter than that in the open surgery group（P0.05）， while the usage of analgesic drugs were also significantly reduced（P0.05）； in additio