腹腔镜在外科急腹症中的应用价值

The application value of laparoscopy in surgical acute abdomen

目的:探讨腹腔镜在外科急腹症诊断和治疗中的应用价值。方法:回顾分析2003年6月至2009年2月应用腹腔镜诊治的27例急腹症患者的临床资料。术前诊断包括开放性腹外伤15例,闭合性腹外伤8例,不明原因腹痛4例。先行腹腔镜常规探查,明确诊断后确定进一步手术方案。结果:确诊26例,漏诊1例。13例在腹腔镜下完成治疗,4例行腹腔镜辅助手术,9例中转开腹。结论:腹腔镜可提高外科急腹症的诊断率,指导医师选择最佳手术切口,制定合理的手术方案,避免了盲目探查的风险,同时具有患者创伤小、康复快等优点,在外科急腹症的临床诊治中有较高的应用价值。

Objective：To discuss the clinical application value of laparoscopy in the diagnosis and treatment of surgical acute abdomen.Methods：The clinical data of 27 patients,who suffered from acute abdomen and underwent laparoscopic diagnosis and treatment from Jun.2003 to Feb.2009 were retrospectively analyzed.The pre-operative diagnosis included 15 cases of open abdominal injury,8 cases of closed abdominal injury,and 4 cases of abdominal pain with unknown reason.The routine laparoscopic exploration was performed at first,the operation programs were determined after the diagnosis was identified.Results：Twenty-six cases of diagnosis were identified and 1 case was misdiagnosed under laparoscopy.13 cases were treated under total laparoscopy and 4 underwent assisted laparoscopy.The other 9 cases were converted to open surgery.Conclusions：Laparoscopy can improve the correct-diagnosis rate of surgical acute abdomen,reduce the blind laparotomy exploration,guide surgeon to choose the optimal incision and reasonable surgical procedure.From our experience,laparoscopy has significant advantages of minimal invasion and quick recovery,and has higher application value in clinical diagnosis and treatment of surgical acute abdomen.