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目的:评价诊断性腹腔镜的检查方法、效果及安全性,提高腹部疑难疾病的早期诊断率。方法:回顾分析58例腹部疑难疾病患者的腹腔镜检查情况,其中腹水原因待查35例,腹水+腹部包块23例。结果:58例患者中诊断为结核性腹膜炎31例,恶性腹膜间皮瘤23例,腹膜转移癌2例,盆腔结核及慢性盆腔炎各1例。不同疾病在腹腔镜下有不同表现。操作时间25-70min,平均38min。并发症为活检处出血4例,其中3例为自限性出血,1例经局部喷洒凝血酶后停止,术后伤口漏水5例。对腹腔镜下有肯定判断的12例患者同时进行治疗。结论:腹腔镜检查具有安全、简便、微创、痛苦小、确诊率高等优点。诊断性腹腔镜值得进一步推广应用。
OBJECTIVE: To evaluate the diagnostic method, efficacy and safety of diagnostic laparoscopy and to improve the early diagnosis rate of difficult diseases in the abdomen. Methods: A retrospective analysis of 58 cases of abdominal diseases in patients with laparoscopic examination, of which 35 cases of ascites due to be investigated, ascites + abdominal mass in 23 cases. Results: Among the 58 patients, 31 cases were diagnosed as tuberculous peritonitis, 23 cases were malignant peritoneal mesothelioma, 2 cases were peritoneal metastasis, 1 case was pelvic tuberculosis and 1 case was chronic pelvic inflammatory disease. Different diseases have different manifestations in laparoscopy. Operating time 25-70min, an average of 38min. Complications were biopsy bleeding in 4 cases, of which 3 cases of self-limiting bleeding, 1 case of local spraying thrombin stopped after wound leakage in 5 cases. Laparoscopic positive judgment of the 12 patients treated at the same time. Conclusion: Laparoscopy is safe, simple, minimally invasive, less painful, the diagnosis rate is high and so on. Diagnostic laparoscopy is worth further promotion and application.