腹腔镜技术在基层医院普外科急腹症诊治中的应用体会  

Application Experience of Laparoscopic Technology in the Diagnosis and Treatment of Acute Abdomen in General Surgery Departments of Primary Hospitals

作　　者：黄清泉 HUANG Qingquan(Department of General Surgery,Hanjiang Hospital,Putian,Fujian 351111,China)

机构地区：[1]莆田涵江医院普外科,福建莆田351111

出　　处：《中国医药指南》2025年第2期127-129,共3页Guide of China Medicine

摘　　要：目的总结在基层医院应用腹腔镜技术诊断和治疗普通外科急腹症的临床经验及价值。方法选取2020年10月至2023年10月莆田涵江医院收治的602例采用腹腔镜手术的普通外科急腹症患者的临床资料,总结分析各种普通外科急腹症患者采用腹腔镜手术的手术体会及经验总结。结果本研究患者中术前诊断急性阑尾炎336例,胆囊结石伴急性胆囊炎158例,消化道穿孔54例,胆总管结石伴急性胆管炎25例,不明原因腹痛21例,急性肠梗阻8例。有593例顺利在腔镜下完成手术,其中开展腹腔镜下阑尾切除术共计354例,开展腹腔镜下胆囊切除术共计158例,开展腹腔镜下胃十二指肠溃疡穿孔修补术共计46例,腹腔镜下胆囊切除+胆总管切开胆道镜取石+T管引流术23例,腹腔镜下右半结肠切除吻合术2例,腹腔镜下乙状结肠修补术2例,腹腔镜下乙状结肠肿瘤切除+预防性末端回肠造口2例,腹腔镜下小肠修补4例,腹腔镜下粘连松解术2例。有9例中转开放手术,其中2例胃后壁溃疡穿孔,1例胃体上段溃疡穿孔,腹腔污染重,予开放修补+活检术;2例为胆总管结石伴急性胆管炎,因为胃术后,局部炎症及粘连严重,予开放行胆囊切除+胆总管切开胆道镜取石+T管引流;2例腹腔粘连严重;2例腹内疝,予中转开腹手术。所有患者均康复出院。结论在基层医院普外科急腹症诊治中实施腹腔镜技术,能够有效改善病情,有助于降低并发症发生率。Objective To summarize the clinical experience and value of using laparoscopic technology in the diagnosis and treatment of general surgical acute abdomen in primary hospitals.Methods A retrospective analysis was conducted on the clinical data of 602 patients with general surgical acute abdomen who underwent laparoscopic surgery at Hanjiang Hospital in Putian from October 2020 to October 2023.The surgical experience and summary of various general surgical acute abdomen patients who underwent laparoscopic surgery were summarized and analyzed.Results Among the patients in this group,336 cases were diagnosed with acute appendicitis before surgery,158 cases with gallstones and acute cholecystitis,54 cases with gastrointestinal perforation,25 cases with common bile duct stones and acute cholangitis,21 cases with unexplained abdominal pain,8 cases with acute intestinal obstruction,593 cases were successfully completed under laparoscopy,and 9 cases were transferred to open surgery.Among them,354 cases underwent laparoscopic appendectomy,158 cases underwent laparoscopic cholecystectomy,46 cases underwent laparoscopic repair of gastric and duodenal ulcer perforation,23 cases underwent laparoscopic cholecystectomy+choledochotomy+bile duct drainage,2 cases underwent laparoscopic right hemicolectomy and anastomosis,2 cases underwent laparoscopic sigmoid colon repair,and 46 cases underwent laparoscopic repair of gastric and duodenal ulcer perforation.2 cases of colon tumor resection+prophylactic terminal ileostomy,4 cases of laparoscopic small intestine repair,Two cases of laparoscopic adhesiolysis.Two cases of perforation of gastric posterior wall ulcers and one case of perforation of upper gastric body ulcers were transferred for open repair and biopsy due to severe abdominal contamination.Two cases involved common bile duct stones accompanied by acute cholangitis.Due to severe local inflammation and adhesion after gastric surgery,open cholecystectomy,common bile duct incision,cholangioscopy for stone removal,and drainage w

关 键 词：急腹症 腹腔镜技术 诊断和治疗 

分 类 号：R656.1[医药卫生—急诊医学]