诊断不明急腹症患者采用腹腔镜探查术较传统开腹手术的优势

The Superiority of Laparoscopy in the Diagnosis of Acute Abdomen Better than that of Traditional Laparotomy

目的探讨不明原因急腹症行腹腔镜探查诊断的临床效果以及较传统开腹探查的临床优势。方法以2013年1月—2018年10月为时限,择取该院急诊科37例常规检查未获得明确诊断的急腹症患者,随机分为实验组(腹腔镜探查术,19例)和对照组(传统开腹探查术,18例),对比观察两组急腹症诊断结果,统计两组基本手术指标,评价疗效与安全性。结果两组疾病检出率、手术成功率均为100.00%,实验组中转开腹10.53%。实验组切口长度(2.7±0.4)cm,疾病确诊时间(50.2±13.6)min,总手术时间(124.6±19.3)min,术中出血量(108.5±30.5)mL,术后住院时间(5.6±2.2)d、术后切口感染率0.00%,腹腔粘连5.26%,各项指标均优于对照组(t=3.576,4.822,6.730,9.415,3.308,χ2=3.562,3.415;P<0.05)。结论腹腔镜探查术诊治不明原因急腹症效果确切,具有创伤小、并发症小、术后恢复快等优势,应用安全可行,值得临床推广。

Objective To investigate the clinical effect of laparoscopic exploration in the diagnosis of unexplained acute abdomen and its advantages over traditional laparotomy. Methods From January 2013 to October 2018, 37 patients with acute abdomen who had not been diagnosed by routine examination were convenient selected and randomly divided into experimental group (laparoscopic exploration, 19 cases) and control group (traditional laparotomy, 18 cases). The diagnostic results of acute abdomen in two groups were compared and observed, and the basic operations in two groups were counted. Indicators to evaluate efficacy and safety. Results The detection rate and the success rate of the disease in both groups were 100.00%, and the experimental group was converted to open flavonoid 10.53%. Incision length (2.7±0.4) cm, disease diagnosis time (50.2±13.6) min, total operation time (124.6±19.3) min, intraoperative blood loss (108.5±30.5) mL, postoperative hospital stay (5.6±2.2) d, postoperative incision infection rate of 0.00%, abdominal adhesions 5.26%, all indicators were better than the control group (t=3.576, 4.822, 6.730, 9.415, 3.308,χ^2=3.562, 3.415;P<0.05).Conclusion Laparoscopic exploration for the treatment of unexplained acute abdomen is effective, with small trauma, small complications, rapid recovery after surgery, etc., the application is safe and feasible, it is worthy of clinical promotion.