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目的通过对普外科急腹症患者采用腹腔镜手术,分析其对急腹症患者的临床诊断与治疗价值。方法选择沾化县第二人民医院普外科2010年1月至2013年1月收治的以急性腹痛入院的236例急腹症患者为研究对象,回顾性分析对其采用腹腔镜手术进行临床诊断与治疗的住院病历资料。汇总分析手术时间、术中出血量、术后下床活动时间、术后进食时间、术后住院天数、术后并发症及伤口愈合等。结果腹腔镜手术确诊率为100%(236/236),术前确诊率为69.92%(165/236),前者显著高于后者(χ2=27.903,P<0.01)。腹腔镜手术成功率为90.25%(213/236),有23例患者中转开腹手术。213例急腹症患者腹腔镜手术时间为(45.1±8.3)min,术中出血量为(79.3±28.2)ml,术后下床活动时间为(21.2±4.7)h,进食时间为(1.8±0.6)d,住院天数为(5.8±1.9)d,手术后出血、止血及伤口愈合情况良好,无大出血及腹腔积液,且未发生与腹腔镜手术相关的并发症及不良反应,无手术死亡病例,213例急腹症患者均痊愈出院。结论腹腔镜微创手术在急腹症的诊断与治疗中具有诊断价值高、治疗手术时间短、出血少、术后恢复快及并发症少等优点,临床可针对具体情况合理选择使用腹腔镜手术治疗急腹症。
Objective To analyze the clinical value of diagnosis and treatment of patients with acute abdomen by laparoscopic surgery. Methods A total of 236 patients with acute abdomen admitted to General Hospital of Zhanhua Second People’s Hospital from January 2010 to January 2013 were enrolled in this study. The clinical data of laparoscopic surgery were analyzed retrospectively Inpatient medical records of treatment information. A total of analysis of the operation time, blood loss, postoperative ambulation time, postoperative eating time, postoperative hospital stay, postoperative complications and wound healing. Results The diagnosis rate of laparoscopic surgery was 100% (236/236). The preoperative diagnosis rate was 69.92% (165/236). The former was significantly higher than the latter (χ2 = 27.903, P <0.01). The success rate of laparoscopic surgery was 90.25% (213/236). Twenty-three patients underwent laparotomy. The laparoscopic operation time was (45.1 ± 8.3) min in 213 patients with acute abdomen, the bleeding volume was (79.3 ± 28.2) ml, the ambulation time was (21.2 ± 4.7) h and the feeding time was (1.8 ± 0.6) d, hospitalization days (5.8 ± 1.9) d, bleeding after surgery, hemostasis and wound healing were good, no major bleeding and ascites, and no complications and adverse reactions associated with laparoscopic surgery, no surgical death Cases, 213 patients with acute abdomen were cured. Conclusion Laparoscopic minimally invasive surgery in the diagnosis and treatment of acute abdomen has high diagnostic value, short operative treatment time, less bleeding, quick recovery and fewer complications, the clinical may choose a specific case of laparoscopic surgery Treatment of acute abdomen.