腹腔镜技术治疗胃肠外科急腹症的临床研究  

Clinical study on laparoscopic technique in the treatment of acute abdomen in gastrointestinal surgery

作　　者：沈涛 黄维贤 吴建忠 SHEN Tao;HUANG Weixian;WU Jianzhong(Department of Gastrointestinal Surgery,Suzhou Ninth People′s Hospital,Suzhou 215200,Jiangsu Province,China)

机构地区：[1]苏州市第九人民医院胃肠外科,江苏省苏州市215200

出　　处：《微创医学》2022年第6期699-702,707,共5页Journal of Minimally Invasive Medicine

摘　　要：目的 探讨腹腔镜技术治疗胃肠外科急腹症的临床效果。方法 选择150例急腹症患者作为研究对象,根据治疗方案将其分为腹腔镜组(n=75)和开腹组(n=75)。比较两组患者的围术期指标(手术时间、术中出血量、术后肛门排气时间、术后下床活动时间、尿管拔除时间、术后住院时间),以及手术前后的炎症指标(CRP、PCT水平)、术后并发症发生情况。结果 两组患者的手术时间比较,差异无统计学意义(P>0.05);腹腔镜组患者的术中出血量少于开腹组,术后下床活动时间、术后肛门排气时间和尿管拔除时间均早于开腹组,术后住院时间短于开腹组(均P<0.05)。术后,两组患者的血清CRP、PCT水平均较术前上升,但腹腔镜组血清CRP、PCT水平均低于开腹组,差异均有统计学意义(均P<0.05)。腹腔镜组并发症总发生率为1.33%,明显低于开腹组的9.33%(P<0.05)。结论 相比于常规开腹手术,采用腹腔镜技术治疗急腹症的效果更优,能减少患者术中出血量,减轻机体应激反应,降低并发症发生率,利于患者术后早期下床活动、缩短住院时间。Objective To investigate the clinical effect of laparoscopic technique in the treatment of acute abdomen in gastrointestinal surgery. Methods A total of 150 patients with acute abdomen were selected as the research objects, and they were divided into laparoscopic group(n=75) and laparotomy group(n=75) according to the treatment plan. The perioperative indicators(operation time, intraoperative blood loss, postoperative anal exhaust time, postoperative ambulation time, urinary catheter removal time, postoperative hospital stay), as well as the inflammatory indicators(CRP, PCT level) before and after surgery, and occurrence of postoperative complications were compared between the two groups. Results There was no statistically significant difference in the operation time between the two group(P>0.05). The intraoperative blood loss in the laparoscopic group was less than that in the laparotomy group, the postoperative ambulation time, postoperative anal exhaust time and urinary catheter removal time in the laparoscopic group were earlier than those in the laparotomy group, and the postoperative hospital stay was shorter than that in the laparotomy group(all P<0.05). After operation, the serum CRP and PCT levels of the two groups were increased compared with those before operation, but the serum CRP and PCT levels in the laparoscopic group were lower than those in the laparotomy group, with statistically significant differences(all P<0.05). The total incidence of complications in the laparoscopic group was 1.33 %, which was significantly lower than the 9.33 % in the laparotomy group(P<0.05). Conclusions Compared with conventional laparotomy, laparoscopic technique has a better effect in the treatment of acute abdomen, which can reduce the intraoperative blood loss, systemic stress responses, and the incidence of complications, benefit patients′ early postoperative ambulation and shorten the hospital stay.

关 键 词：腹腔镜技术 胃肠外科 急腹症 C反应蛋白 降钙素原 临床效果 

分 类 号：R656.1[医药卫生—急诊医学]