腹腔镜探查术在急腹症中的诊治应用(附62例报告)

Application of Laparoscopic Exploration in the Diagnosis and Treatment of Acute Abdomen(Report of 62 Cases)

目的探讨在外科急腹症诊疗过程中应用腹腔镜技术的可行性。方法回顾性分析2017年4—9月在我院行腹腔镜探查及手术治疗的62例普外科急腹症患者的临床资料。结果 62例患者于腹腔镜下顺利完成手术,手术时间30~115 min,平均为(64.3±3.7)min。无中转开腹。62例患者术中均放置腹腔引流管(穿孔灶旁引流管、盆腔引流管),一般于术后2~5天内拔除。住院时间4~12天,平均为(7.1±0.5)d,操作孔感染病例1例,予以换药1周后好转,无肠管、输尿管损伤及肠瘘发生,无严重并发症,无死亡病例。结论腹腔镜手术具有创伤小、疼痛轻、肠道功能恢复快、切口感染率低、住院时间短等优势,用于诊断急腹症可行、安全、有效。

Objective To explore the feasibility of laparoseopie exploration in the diagnosis and treatment of patients with surgical acute abdomen. Methods The elinical data of 62 eases of patients with acute abdomen who underwent laparoseopie exploration and surgical treatment in our hospital from April to September 2017 were retrospeetively analyzed. Results The operation time was 30 - 115 minutes, the average time was （64.3±3.7） minutes. There were no transfer to open the abdomen. 62 cases of patients were placed abdominal drainage tube （perforated stove adjacent drainage tube, pelvic drainage tube）, usually removed within 2 - 5 days after surgery. The hospitalization time was 4 - 12 days, the average time was （7.1±0.5） d, operation hole infection in 1 ease, and got improved after 1 week of dressing, there was no bowel, ureteral injury and intestinal fistula occurred, no serious complications and no deaths. Conclusion Laparoscopic surgery has the advantages of less trauma, mild pain, quick recovery of intestinal function, low incision infection rate and short hospitalization time. It is feasible, safe and effective to diagnose acute abdomen.