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目的观察腹腔镜治疗妇科急腹症的临床疗效及其对高敏C反应蛋白(hs-CRP)和前白蛋白(PA)的影响。方法将2009年1月至2011年6月妇科急腹症的153例患者按照手术方式不同分为腹腔镜组(65例)和开腹组(88例)。观察两组患者手术时间、术中出血量、术后排气时间、疼痛分数(VAS)、住院时间、PA和hs-CRP的变化。结果治疗后,腹腔镜组的手术时间、术中出血量、肛门排气时间、疼痛分数、住院时间和并发症发生率均较开腹组短或者减少,两组比较差异有统计学意义(P<0.01)。hs-CRP水平两组治疗后均较治疗前明显降低,但腹腔镜组较开腹组组降低更为明显(P<0.01)。相反,PA水平均较治疗前明显提高,但腹腔镜组较开腹组提高更为明显(P<0.01)。结论腹腔镜治疗妇科急腹症安全有效,术后恢复快,是妇科急腹症的主要手术方式。
Objective To observe the clinical efficacy of laparoscopic gynecologic acute abdomen and its effect on high sensitivity C-reactive protein (hs-CRP) and prealbumin (PA). Methods 153 patients with gynecologic acute abdomen from January 2009 to June 2011 were divided into laparoscopic group (65 cases) and open group (88 cases) according to the operation method. The operation time, intraoperative blood loss, postoperative exhaust time, pain score (VAS), length of hospital stay, changes of PA and hs-CRP in both groups were observed. Results After operation, the operation time, blood loss, anal exhaust time, pain score, hospital stay and complication rate in laparoscopic group were shorter or lower than those in laparotomy group (P <0.01). hs-CRP levels in both groups were significantly lower than those before treatment, but the laparoscopic group was more significantly lower than the open group (P <0.01). On the contrary, PA levels were significantly higher than before treatment, but the laparoscopic group was more obvious than the open group (P <0.01). Conclusions Laparoscopic treatment of gynecological acute abdomen is safe and effective, rapid recovery after surgery is the main surgical treatment of gynecologic acute abdomen.