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目的探讨腹腔镜探查术在急腹症诊断和治疗中的应用价值。方法对收治的40例具有急性腹痛、不同程度腹部压痛和反跳痛等腹膜刺激征患者进行腹腔镜探查。结果 40例全部在腹腔镜下获得诊断,漏诊2例,均为多发伤中的腹膜间位器官,确诊率95%,28例同时完成治疗,其中5例仅为置管引流,4例无需手术治疗,8例确诊后中转开腹,治疗率70%。漏诊2例,术后再次出现腹膜炎症状而开腹探查,1例出现肠粘连并发症。2例结肠肿瘤穿孔患者中转开腹后有1例出现切口感染。结论腹腔镜探查术是直观、准确、安全、微创的探查手段,其适用于一般辅助检查不能明确诊断的急腹症患者,其作用不单在于明确诊断,而且兼有治疗作用,且术后痛苦轻、恢复快、并发症少,但中转率较高。
Objective To investigate the value of laparoscopy in the diagnosis and treatment of acute abdomen. Methods Forty patients with peritoneal irritation, including acute abdominal pain, varying degrees of abdominal tenderness and rebound pain, were examined by laparoscopy. Results All 40 cases were diagnosed laparoscopically and 2 cases were missed. All of them were peritoneal organs in multiple trauma. The diagnosis rate was 95%. 28 cases were treated at the same time. Among them, 5 cases were only treated by catheter drainage and 4 cases were operated without surgery Treatment, 8 cases of laparotomy after diagnosis, the treatment rate of 70%. Misdiagnosis in 2 cases, again after the onset of symptoms of peritonitis and laparotomy, intestinal complications occurred in 1 case. Two cases of colorectal tumor perforation patients after laparotomy in 1 case of incision infection. Conclusions Laparoscopy is an intuitive, accurate, safe and minimally invasive exploration method. It is suitable for patients with acute abdomen who can not be definitely diagnosed by general auxiliary examination. Its function is not only a definite diagnosis, but also a therapeutic effect, and postoperative pain Light, fast recovery, fewer complications, but the higher transfer rate.