针式诊断性腹腔镜与常规诊断性腹腔镜的临床应用对比研究

Comparative Analysis on Clinical Application of Minilaparoscopy and Conventional Laparoscopy in Diagnosing Complicated Ascites Diseases

目的探讨针式诊断性腹腔镜(直径5mm)对腹腔疑难疾病诊断的临床应用价值。方法50例不明原因腹水患者随机分成针式腹腔镜检查组和常规腹腔镜检查组,各25例。分别利用针式腹腔镜和常规腹腔镜(直径10mm)进行检查,比较两组的检查情况、确诊率及不良反应等。结果50例患者中有49例明确诊断,其中结核性腹膜炎32例,恶性腹膜间皮瘤11例,转移性腺癌5例,印戒细胞癌1例。针式腹腔镜操作流畅,视野大而清晰。针式组检查时间明显短于常规组检查时间(分别为28±6min和36±9min,P<0.01),两组确诊率[分别为96%(24/25)与100%(25/25)]无显著差异(P>0.05)。两组均无严重并发症发生。结论针式诊断性腹腔镜与常规腹腔镜相比操作顺畅而效果相同,且针式镜损伤更小,操作更方便,患者痛苦更小。

Objective To study the clinical value of minilaproscopy （5 mm in diameter） in diagnosing complicated ascites diseases. Methods 50 patients with ascites of unknown causes were randomly divided into minilaparoscopy group and conventional laparoscopy group,25 patients in each;minilaparoscopy and conventional laparoseopy （10 mm in diameter） were made respectively, and the examination results, confirmed diagnosis rate and adverse reaction were compared between the two groups. Results Accurate diagnosis was gained in 49 cases out of the 50 ： 32 cases with tuberculous peritonitis, 11 cases with malignant peritoneal mesothelioma,5 with peritoneum metastatic adeuocarcinoma and 1 with signet-ring cell carcinoma;the time for minilaparoscopy was significantly shorter than that for conventional laparoscopy （28 ± 6 min and 36 ± 9 min respectively, P 〉 0.01 ）, the confirmed diagnosis rate in beth groups showed no significant difference （96 % and 100 % respectively, P 〉 0.05） ;No severe complications occurred in both groups. Conclusions The performance of minilaparoscopy is easier than that of conventional laparoscopy but with the same effect, causes smaller injury and less suffering in patients.