克罗恩病的腹腔镜诊治策略  

The strategy of diagnosis and therapy of laparoscope in Crohn's disease

作　　者：张贵年[1] 黄顺荣[1] 秦千子[1] 麦威[1] 

机构地区：[1]广西壮族自治区人民医院胃肠外科,广西南宁530021

出　　处：《中国内镜杂志》2012年第5期528-530,共3页China Journal of Endoscopy

摘　　要：目的探讨克罗恩病的腹腔镜诊治策略,最大限度避免并发症和复发的发生。方法回顾性分析12例克罗恩病在腹腔镜下进行诊治策略。结果 12例均在腹腔镜下手术顺利完成,无中转开腹,术前确诊5例(41.7%),经腹腔镜探查术后明确为克罗恩病7例(58.3%),手术平均时间为(180.0±42.1)min,术中平均失血为(201.1±5.4)mL,手术后平均住院天数(12.1±4.5)d,切口感染2例(16.67%),吻合口瘘1例(8.33%),术后随访6个月～6年,4例复发,复发率(33.3%),再手术1例,取得与开腹手术相同的疗效。结论克罗恩病的腹腔镜诊治要有整体治疗的策略,需结合患者全身状况和临床病期把握手术指征、时机与术式选择,才能有效地避免并发症和复发的发生,提高患者生存质量,体现微创手术的优势。[ Objective ] To explore the strategy of laparoscope in the diagnosis and therapy of Crohn＇s disease to avoid the complications and recrudescence. [Methods] The clinic data of 12 patients treated with laparoscope was reviewed. [Results] All the cases were cured under laparoscope suecesstully without conversions to open surgery. Five eases were diagnosed before the operation （41.7%）, the other 7 cases were diagnosed by the operation （58.3%）. The mean operation time was （180±42.1） rain, the mean blood lost was （201.1±5.4） mL, and the mean hospital day after operation was （12.1±4.5） days. Two cases suffered incision infection （16.67%）, one case suffered fistula （8.33%）. All the cases were followed up 6-72 months, 4 cases suffered recrudescence （33.3%）, l case had to be operated again. The curative effect was equal to open operation. [ Conclusions] Holistic strategy of diagnosis and therapy was necessary to Crohn＇s disease with laparoscope. Grasping the patient＇s systemic condition, choosing the correct operation indicating, time, and treatment was important to avoid e, omplications and recrudescence and improve the patient＇s life quality.

关 键 词：克罗恩病 腹腔镜 诊治策略 

分 类 号：R57[医药卫生—消化系统]