摘要
目的 探讨女性下腹部急腹症的手术途径。方法 回顾性分析 1996～ 1999年间应用微型腹腔镜或开腹手术治疗的 6 8例原因不明的女性下腹部急腹症病人的临床资料。结果 微型腹腔镜组诊断率为 94 5 9%(35 / 37) ,治愈率 75 6 8% (2 8/ 37) ,结合传统腹腔镜器械 ,诊断率和治愈率为 10 0 %和 91 89% (34 / 37)。微型腹腔镜组术后并发症为 2 70 % (1/ 37) ,开腹组为 16 13% (5 / 31) ,两者相比ARR为 13 43% ,NNT为 7 4;微型腹腔镜组术后住院天数、镇痛剂应用和肠道功能恢复情况与开腹组相比差异有显著意义 (P <0 0 1)。结论 女性原因不明的下腹部急腹症可考虑首选微型腹腔镜探查 ,必要时结合传统腹腔镜器械治疗 。
Objective To evaluate the surgical way for acute abdomen in lower quadrants in women. Methods Between 1996 and 1999, 68 women underwent microlaparoscopy or laparotomy for a lower acute abdomen of unknown origin, their clinical data were analyzed retrospectively. Results The diagnostic and therapeutic accuracy were 94.59% (35/37) and 75.68% (28/37) respectively in microlaparoscopy group, they would rise up to 100% and 91.89% (34/37) when combined with conventional laparoscopy. The postoperative complication in microlaparoscopy group was 2.70% (1/37), it was 16.13% (5/31) in laparotomy group, the absolute risk reduction (ARR) of complication was 13.43%, the number needed to treat (NNT) was 7.4 cases. The microlaparoscopy group had significantly shorter hospital stay, less requirement for analgesics and more rapid intestinal recovery than laparotomy group (P<0.01). Conclusion The microlaparoscopy can be used as the first diagnostic procedure for lower acute abdomen of unknown origin in women. The conventional laparoscopy is performed in treatment as a secondary instrument if necessary. In difficult cases, the microlaparoscopy can indicate the best incision for conversion to laparotomy.
出处
《中国实用外科杂志》
CSCD
北大核心
2002年第2期101-102,共2页
Chinese Journal of Practical Surgery
