腹腔镜诊治急腹症615例临床分析

Diagnosis and treament of acute abdomen by laparoscope in 615 cases

目的探讨腹腔镜技术在外科急腹症中的应用价值。方法回顾分析2000年3月-2005年5月615例腹腔镜急诊手术。结果本组615例全部术中明确诊断,腹腔镜手术成功578例,其中急性阑尾炎193例,急性胆囊炎394例,上消化道穿孔7例,外伤性脾破裂5例,重症胰腺炎引流4例,急性化脓性盆腔炎11例,急性梗阻性化脓性胆管炎1例,成功率94.0%(578/615)。余37例中转开腹。结论急诊腹腔镜探查术不仅可以对病因不明的急腹症作出准确诊断,而且90%以上病变可同时进行腹腔镜手术治疗。

Objective To explore the value of laparoscope in the treatment of acute abdomen. Methods From March 2000 to May 2005, the clinical data of 615 cases undergoing emergent laparoscopic operation were analyzed. Results All patients were diagnosed during exploration. Laparoscopic operations were successfully completed in 578 cases （193 of acute appendicitis, 394 of acute cholecystitis, 7 of upper gastrointestinal tract perforation, 5 of traumatic spleen rupture, 4 of severe acute pancreatitis, 11 of acute suppurative pelvic inflammation, 1 of acute suppurative obstructive cholangitis）, with a success rate of 94.0% （578/615）, The remaining 53 patients underwent a conversion to open surgery. Conclusions Emergency laparoscopic exploration can not only clarify the diagnosis of acute abdomen with unknown causes, but also simultaneously offer a therapeutic method in at least 90% of cases.