急腹症患者行急诊腹腔镜检查和治疗的临床应用价值分析

The analysis of the clinical value for the application of emergency laparoscopic examination and treatment in patients with acute abdomen

目的分析探讨急诊外科中运用腹腔镜诊断和治疗急腹症患者的临床意义。方法以我院急诊外科2009年6月至2011年4月收治的54例胃十二指肠溃疡穿孔患者为研究对象。将其随机分为两组,腹腔镜组和传统开腹组。观察并比较两组患者临床治疗效果及并发症发生情况。结果 (1)腹腔镜组患者术中出血量和术后镇痛次数明显少于开腹组患者,肛门排气时间也明显短于传统开腹组(P<0.05);(2)腹腔镜组患者术后进食时间和下床活动时间明显缩短(P<0.05),住院时间也明显短于传统开腹组(P<0.05);(3)腹腔镜组患者术后并发症发生几率明显小于传统开腹组(P<0.05)。结论将腹腔镜技术应用于急诊急腹症患者中同时具有诊断和治疗的双重作用,是一种安全、有效的诊疗手段,临床上值得推广。

Objective To analyze and explore the clinical significance of the use of laparoscopic diagnosis and treatment in patients with acute abdomen in emergency surgery.Methods Fifty-four cases of gastric ulcer perforation admitted in our hospital for emergency surgery from June 2009 to April 2011 were chosen as the research object.They were randomly divided into two groups,the laparoscopic group and the traditional open surgery group.The clinical treatment effect and occurrence of complications for the two groups of patients was observed and compared.Results （1）The blood loss and the number of postoperative analgesia in the laparoscopic group of patients was significantly less than the laparotomy patients,anal exhaust time was significantly shorter than the traditional open surgery group（P0.05）.（2）The eating time and ambulation time in the laparoscopic group of patients was significantly shorter（P0.05）,and the length of hospital stay was significantly shorter than the traditional open surgery group（P0.05）.（3）The postoperative complications occurred in the laparoscopic group was significantly smaller than the traditional open surgery group（P0.05）.Conclusion The laparoscopic technique used in emergency patients with acute abdomen has a dual role in diagnosis and treatment at the same time.It is a safe and effective treatment means.It is worthy of promoting in the clinical application.