针式诊断性腹腔镜的临床应用

Clinical Application of Minilaparoscopy

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。方法应用针式诊断性腹腔镜对29 例不明原因腹水患者进行检查,其中腹水22例,腹水+腹部包块7例,分析其检查情况并与常规诊断性腹腔镜进行对比。结果针式腹腔镜操作流畅,视野大而清晰。29例全部顺利完成检查,检查时间21-38 min平均28±6 mini。所有病例腹腔镜下均有其特定的表现。29例患者中有28例明确诊断,确诊率96．6％。其中结核性腹膜炎19例,恶性腹膜间皮瘤6例,转移性腺癌2例,印戒细胞癌1例。无明显并发症发生。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,且针式镜对患者损伤更小,医者操作更方便, 患者瘫苦更小。

Objective To explore the clinical value of miniaparoscopy （5 mm in diameter） to the diagnosis of complicated ascites diseases. Methods A retrospective analysis was performed on 29 patients who underwent mlnilaparoscopy, of all patients ,22 with ascites of unknown origin, 7 with ascites and celiac masses. Minilaparoscopy was compared with conventional laparoscopy. Results Minilaparoscopic procedure was smooth. The visual field was wide enough and clear. Minilaparoscopy was successfully performed in all 29 patients. The operational tlme was 21～38 min, and the average was 28±6 min. Different visualization at laparoscopy was observed in different diseases. Final diagnosis was made in 28 patients. The rate of correct diagnosis was 96.6%. Of 29 patients, 19 were diagnosed as tuhcrcnlous peritonitis ,6 were malignant peritoneal mesothelioma,2 were peritoneum metastatic adenocareinoma,and 1 was signet-ring cell carcinoma. No severe complication was observed, Conclusion Compared with conventional laparoscopy, minilaparoscopy procedure is smooth and has same result. There are less wound and hurt, more on convenient procedure and fewer suffering in minilaparoscopy.