腹腔镜诊治急腹症在基层医院的临床应用

The clinical application of laparoscopy in diagnosis and treatment of acute abdomen in local hospitals

目的:探讨腹腔镜手术诊治急腹症的临床应用价值。方法:回顾分析2006年1月至2013年2月116例腹腔镜急诊手术的临床资料,其中急性胆囊炎48例,急性阑尾炎32例,胃十二指肠穿孔19例,闭合性腹部损伤12例,宫外孕1例,黄体破裂1例,急性盆腔炎2例,大网膜蒂扭转坏死1例。结果:102例顺利完成腹腔镜手术,14例中转开腹;无严重并发症发生及死亡病例。结论:腹腔镜技术诊治外科急腹症,在明确诊断的同时可进行治疗,手术成功率高,使患者避免了不必要的剖腹手术,疗效好,值得进一步推广应用。

Objective： To explore the clinical value of laparoscopy in diagnosis and surgical treatment of acute abdomen. Meth- ods：A retrospective study was carried out through collecting the clinical data of 116 cases of emergency laparoseopic surgery from Jan. 2006 to Feb. 2013. The indications of surgery were acute cholecystitis （n =48 ）, acute appendicitis （n = 32）,gastric and duodenum perforation （ n = 19 ） , closed abdominal injuries （ n = 12） , ectopic pregnancy （ n = 1 ） , ruptured corpus luteum （ n = 1 ） , acute pelvic in- flammatory disease （n = 2） and necrotic omental pedicle torsion （n = 1 ）. Results：The laparoscopic surgery succeeded in 102 cases, 14 cases were converted to laparotomy,death and serious complication was not observed in any patients. Concluslons：Laparoscopic tech- nique is minimally invasive and efficient, has advantages such as making a confirmed diagnosis as soon as possible for patients with a- cute abdomen, providing therapy at the same time with high success rate, which avoids unnecessary laparotomy and deserves promotion in local hospitals.