腹腔镜手术在急性盆腔炎诊断和治疗中的作用  

Role of laparoscopic surgery in diagnosis and treatment of acute pelvic inflammatory disease

作　　者：毛玉荣[1,2] 浦红[1,2] 张振宇[1,2] 董若凡[1,2] 陆英华[1,2] 

机构地区：[1]江南大学附属医院 [2]江苏省无锡市第四人民医院妇瘤科,214062

出　　处：《中国妇幼保健》2015年第29期5069-5071,共3页Maternal and Child Health Care of China

基　　金：江苏省无锡市卫生局科技支撑计划〔201001225〕

摘　　要：目的研究分析腹腔镜在急性盆腔炎的诊断及治疗中的作用价值。方法采用回顾性分析方法，2011年7月-2014年12月的67例患者采用腹腔镜进行探查，对确诊患者进行腹腔镜手术＋抗生素治疗（腹腔镜组），2011年10月-2014年6月的65例经临床确诊急性盆腔炎患者采取单纯静脉给药治疗（保守治疗组），以临床最终诊断结果作为金标准，分析腹腔镜在诊断急性盆腔炎中的临床价值，并对比两种方法治疗急性盆腔炎的临床效果。结果腹腔镜进行探查结果与临床确诊结果相符60例诊断符合率95．23％。腹腔镜组的腹痛消失时间、体温恢复时间、白细胞恢复时间、住院时间均显著低于保守组患者（P〈0．05）。治疗3d后腹腔镜组的CRP、WBC、体温均显著低于保守组患者（P〈0．05）。腹腔镜组患者术后盆腔包块数目、再次手术发生率、盆腔疼痛发生率均显著低于保守组（P〈0．05）。腹腔镜组患者的治愈率50．79％、总有效率100．00％均显著高于保守组的30．77％、90．77％，P〈0．05。结论腹腔镜在急性盆腔炎的诊断及治疗中均具有较高的临床实用价值。Objective To research and analyze the function and value of laparoscope in diagnosis and treatment of acute pelvic in- flammatory disease. Methods Sixty-seven patients receiving laparoseopic exploration from July 2011 to December 2014 were analyzed ret- rospeetively; the patients diagnosed as acute pelvic inflammatory disease definitely underwent laparoseopic surgery and antibiotic treatment （laparoscopy group） ; 65 patients diagnosed as acute pelvic inflammatory disease definitely were treated by single venous administration from October 2011 to June 2014 （conservative treatment group） ; the final clinical diagnostic result was gold standard, the clinical value of lapa- roscopy in diagnosis of acute pelvic inflammatory disease was analyzed, the clinical effects of two methods in treatment of acute pelvic inflam- matory disease were compared. Results The diagnostic coincidence rate of laparoscopic exploration and clinical diagnosis was 95.23%. The disappear time of abdominal pain, temperature recovery time, leukocyte recovery time, and hospitalization time in laparoscopy group were statistically significantly lower than those in conservative treatment group （P〈0.05） . After three days of treatment, CRP, WBC, and temperature in laparoscopy group were statistically significantly lower than those in conservative treatment group （P〈0. 05） . The number of pelvic masses, the incidence rates of reoperation and pelvic pain after surgery in laparoscopy group were statistically significantly lower than those in conservative treatment group （P〈0. 05） . The cure rate and total effective rate in laparoscopy group were 50. 79% and 100.00%, respectively, which were statistically significantly higher than those in conservative treatment group （30. 77% and 90. 77% ） （P〈0.05） . Conclusion Laparoscopy has relatively high clinical practical value in diagnosis and treatment of acute pelvic inflammatory disease.

关 键 词：腹腔镜 急性盆腔炎 诊断 治疗 价值 

分 类 号：R711.33[医药卫生—妇产科学]