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目的探讨腹腔镜对妇科急腹症的诊疗价值。方法回顾性分析广西壮族自治区民族医院妇产科2011年3月至2013年3月收治的152例妇科急腹症患者的临床资料,76例经腹腔镜手术治疗患者为观察组,76例经普通开腹手术治疗患者为对照组,比较两组患者手术成功率、手术指标、术后并发症及术后疼痛视觉模拟评分法(visual analog scale,VAS)评分和术后疼痛恢复时间。结果两组患者手术成功率均为100%,观察组患者术中出血量(37.6±9.7)m L、手术时间(53.8±6.2)min、肛门排气时间(22.3±3.5)h、住院天数(7.5±2.6)d、术后4 h VAS疼痛评分(2.2±2.3)分、术后24 h VAS疼痛评分(4.8±4.5)分、术后疼痛恢复时间(5.7±2.3)h,均少于对照组[分别为(81.7±8.4)m L、(74.9±8.1)min、(32.2±5.7)h、(12.9±3.7)d、(6.9±4.9)分、(7.3±5.7)分、(12.6±4.9)h](均P<0.05)。结论腹腔镜治疗妇科急腹症安全有效,在其诊疗中具有较高的应用价值。
Objective To investigate the value of laparoscopy in diagnosis and treatment of gynecologic acute abdomen. Methods The clinical data of 152 patients with gynecologic acute abdomen treated in Department of Obstetrics and Gynecology, Minzu Hospital of Guangxi Zhuang Autonomous Region from March 2011 to March 2013 were retrospectively analyzed. Among 76 patients who underwent laparoscopic surgery, 76 were diagnosed as normal The patients undergoing laparotomy as the control group were compared in terms of operation success rate, operation index, postoperative complications, postoperative pain visual analog scale (VAS) score and postoperative pain recovery time. Results The successful rate of operation in both groups was 100%. The intraoperative blood loss (37.6 ± 9.7) m L, operation time (53.8 ± 6.2) min, anal exhaust time (22.3 ± 3.5) h, hospitalization days 7.5 ± 2.6) d. VAS pain score (2.2 ± 2.3) at 4 h postoperatively, VAS pain score (4.8 ± 4.5) at 24 h postoperatively, postoperative pain recovery time (5.7 ± 2.3) h, (81.7 ± 8.4) m L, (74.9 ± 8.1) min, (32.2 ± 5.7) h, (12.9 ± 3.7) d, (6.9 ± 4.9), (7.3 ± 5.7) 4.9) h] (all P <0.05). Conclusions Laparoscopy is safe and effective in the treatment of gynecologic acute abdomen and has high value in diagnosis and treatment.