腹腔镜在小儿急腹症中的临床应用及分析

Clinical application and analysis of laparoscopy in acute abdomen in children

目的探讨腹腔镜在小儿急腹症的诊断和治疗过程中的作用和优势。方法结合对该院2006年1月～2011年3月采用腹腔镜诊治的81例小儿急腹症病例的总结,分析腹腔镜在小儿急腹症的诊断和治疗过程中的作用和优势。结果 81例小儿急腹症通过腹腔镜明确诊断80例,1例中转常规进腹手术后确诊;腹腔镜直接完成手术54例,腹腔镜辅助下完成手术19例,进腹手术8例。所有病例均得到及时治疗,1例坏疽穿孔性阑尾炎,术后右上腹10mm Trocar孔切口裂开,同时腹腔内残余感染,予换药,加强抗感染后治愈,其余病例恢复良好,随访4个月～5年无腹痛及粘连性肠梗阻等相关并发症。结论腹腔镜应用于小儿急腹症,可直接手术或协助常规进腹完成手术。具有确诊率高,探查全面,损伤小,恢复快等优点。

[Objective] To explore the role and advantages of laparoscopy in the diagnosis and treatment of children with acute abdominal process. [Methods ] 81 cases of pediatric acute abdomen underwent laparoscopic surgery in our hospital from January 2006 to March 2011 were reviewed and the role and advantages of laparoscopy in the diagnosis and treatment of pediatric acute abdomen were analyzed. [ Results ] 80 cases of acute abdomen in children had been diagnosed by laparoscopy, and one case had been diagnosed after transferred into the routine ab- dominal surgery. Laparoscopic surgery was done directly in 54 cases, laparoscopic assisted surgery done in 19 cases, into the abdominal surgery in 8 cases. All patients were treated timely. One case of gangrenous perforated appendici- tis surgery, right upper quadrant 10mm Trocar hole wound dehiscence, and residual intra-abdominal infections, for dressing to enhance the anti-infection. The remaining patients recovered well. Followed up for 4 months to 5 years was without abdominal pain and adhesive intestinal obstruction and other related complications. [ Conclusions ] La- paroscopic used in pediatric acute abdomen, can directly surgery or assist in routine into the abdominal surgery, and has the advantages of high rate of diagnosis, a comprehensive exploration, small damage, quick recovery, etc.