腹腔镜在外科急腹症诊治中的价值

Value of Laparoscopy in Diagnosis and Treatment of Acute Abdominal Disease

目的：研究急诊腹腔镜探查术对急腹症患者的诊治价值。方法对32例急腹症患者行急诊腹腔镜探查术。结果32例患者术中均明确诊断，其中行阑尾切除术10例，消化道穿孔修补术12例，肠粘连肠松解术6例，脾脏包膜下出血探查术2例，结核性腹膜炎活检2例。顺利完成腹腔镜手术者31例，手术成功率为96.9%，1例中转开腹手术进行胃穿孔修补术。患者术后住院3～5 d，均痊愈出院，随访1～3个月，均无不适症状。结论急诊腹腔镜检查明显提高了急腹症术前诊断率，对急腹症手术时机和手术方式的合理选择有极大的临床应用价值。

Objective To explore the clinical value of laparoscopy in the diagnosis and treatment of acute abdominal disease. Methods Thirty-two patients with acute abdominal disease underwent lapa-roscopy before operation. Results All the 32 patients were unequivocally diagnosed during the operation. Among them, appendectomy was performed in 10, gastrointestinal perforation repair in 12, intestinal adhesion lysis in 6, exploratory surgery for splenic subcapsular hemorrhage in 2, and tuberculous peritonitis biopsy in 2.Thirty-one patients （96.9%） successfully underwent laparoscopic surgery, and 1 patient was converted to open surgery for gastric perforation. Patients were discharged from hospital after 3-5 days of hospitalization and had no discomfort symptoms after 1-3 months of follow-up. Conclusion Emergency laparoscopy can significantly improve the preoperative diagnosis rate of acute abdominal disease, and is of great value in the reasonable selection of surgery timing and method.