现代腹腔镜在诊治慢性腹痛中的临床应用

The Application of Modern Laparoscopy to the Diagnosis and Treatment in Chronic Abdominal Pain

目的 探讨应用现代胜利腹腔镜技术诊治慢性腹痛的临床经验。方法１９９３年以来，选择６０例腹痛部位相对固定、已除外妇科与消化科疾病的慢性腹痛患者，经腹腔镜探查腹痛原因并进行相应的手术治疗。结果 腹腔镜探查均获成功，未发生手术并发症。３５ 例接受了腹腔镜阑尾切除术与腹腔粘连松解；２０例接受了单纯的腹腔粘连松解；另５例腹腔镜探查仅发现盆腔有轻度炎症表现，只予单纯冲洗处理。４５例术后随访了半年至５年，２４例腹痛症状基本消失，１３ 例腹痛症状有所减轻，８例腹痛没有缓解。完全缓解率为５３％，部分缓解率为２９％，总有效率为８２％。结论 现代腹腔镜诊治慢性腹痛具有探查范围广、诊疗一体化、便于跨学科联合、以及微创高效的独特优势。

Objective To evaluate the role of laparoscopic exploration in patients with chronic abdominal pain. Methods Sixty patients with chronic abdominal pain were selected for laparoscopic evaluation. Results of 60 patients, 35 cases were operated on by laparoscopic appendectomy and lysis of adhesion,20 cases by lysis of ad- hesion simply, and 5 cases by simple irrigation of the pelvis. Forty five patients were followed up from 0.5 to 5 years, complete pain relief rate was 53 % (24/45), partial pain relief rate was 29% (13/45), the other 18% (8/45)got no im- provement of their addominal pain. Conclusions Laparoscopic diagnosis and treatment in patients with chronic ab- dominal pain have the following advantages: extensive exploration, multidisciplinary diagnosis and treatment in combi- nation, as well as accuracy and effectiveness.