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目的:探讨腹腔镜在妇科急腹症的应用价值,对手术的适应症及可能出现的问题进行讨论。方法:回顾性分析2004-11-2010-10湖北省沙洋人民医院妇产科收治的570例妇科急腹症患者,根据手术方式分为两组:A组:常规开腹手术组共207例;B组:腹腔镜手术组共363例,对比分析两组患者疗效及术后并发症。结果:所有患者均行急诊手术,无手术死亡病例,其中B组患者中14例中转开腹(中转率3.9%),在平均住院时间,胃肠道功能恢复时间及术后并发症方面显著低于A组患者(P<0.05),B组部分患者术后出现皮下气肿、腹壁血管损伤及皮下淤血等,均经保守治疗痊愈。结论:有经验的医师采用腹腔镜治疗妇科急腹症具有诊断和治疗双重意义,且损伤小、恢复快,具有较高的临床价值,值得在基层医院推广。
Objective: To investigate the value of laparoscopy in the treatment of gynecologic acute abdomen and to discuss the indications and possible problems of surgery. Methods: A retrospective analysis of 570 cases of gynecologic acute abdomen admitted to Department of Obstetrics and Gynecology, Shayang People’s Hospital of Hubei Province from 2004-11-2010-10 was divided into two groups according to the operation mode: Group A: 207 cases of conventional laparotomy group ; Group B: a total of 363 cases of laparoscopic surgery group, comparative analysis of two groups of patients efficacy and postoperative complications. Results: All patients underwent emergency surgery without any surgical death. Of the 14 patients in Group B who underwent laparotomy (median conversion 3.9%), they were significantly lower in mean length of stay, gastrointestinal function recovery time and postoperative complications In group A (P <0.05), some patients in group B developed subcutaneous emphysema, abdominal vascular injury and subcutaneous congestion after conservative treatment. Conclusion: Experienced physicians using laparoscopy for the diagnosis and treatment of gynecological acute abdomen have dual meanings, and the damage is small and fast recovery, with high clinical value, it is worth to promote in primary hospitals.