早期腹腔镜探查在非弥漫性腹膜炎腹痛患者中的应用价值

Value of early laparoscopy in the abdominal pain patients with non-diffuse peritonitis

目的探讨早期腹腔镜探查在非弥漫性腹膜炎腹痛患者中的应用价值。方法收治腹痛待查患者共187例,均无弥漫性腹膜炎体征,初步检查后未能明确诊断。随机分成两组:A组(腹腔镜探查组,91例)早期行腹腔镜探查术,并针对探查结果采取相应治疗措施;B组(观察诊疗组,96例)按传统诊疗方案观察治疗。比较两组患者的诊断率、治愈率、并发症发生率、接受放射学检查次数、住院时间、住院费用、患者满意度等指标。结果 A组在确诊率、治愈率、接受放射学检查次数、住院时间、患者满意度上均优于B组,两组差异有统计学意义(χ2分别=18.31、12.58;t分别=3.49、2.71、1.95,P均<0.05),并发症发生率两组差异无统计学意义(χ2=1.48,P>0.05),住院费用A组大于B组(t=1.76,P<0.05)。结论早期腹腔镜探查对非弥漫性腹膜炎患者具有较高的诊断和治疗价值,能有效减少放射学检查次数,减少住院时间,提高患者的满意度,但目前阶段住院费用较大。

Objective To investigate the value of early laparoscopy in the abdominal pain patients with non-diffuse peritonitis.Methods All 187 abdominal painful patients for which the diagnosis remains uncertain after baseline examination were randomly divided to two groups,the patients of group A accepted early laparoscopy,then accepted relative therapies according to the result of exploration;the patients of group B accepted active observation.The terms such as diagnostic rate,therapeutic utility,mortality,the times of radio-examination,cost,hospital stay,and quality of life were compared between the groups.Results The outcomes of group A in terms of diagnostic rate,therapeutic utility,the times of radio-examination,hospital stay,and quality of life were better than those of group B（χ2 =18.31,12.58;t =3.49,2.71,1.95,P0.05）,however,the cost of group A was more than that of the group B（t =1.76,P0.05）,there was no difference of complications between two groups.Conclusions Early laparoscopy performed better in establishing a final diagnosis and therapeutic utility,reduced the times of radio-examination and hospital stay,improved quality of life,however more cost was needed.