Application Of Laparoscopy In The Diagnosis And Treatment Of Acute Abdomen

Objective The purpose of this study is to track the clinical outcome of patients with acute abdomen with different exploration methods after treatment,to evaluate the superiority of laparoscopy in acute abdomen application,provide accurate reference for clinical treatment of acute abdomen.Methods 250 patients with acute abdomen from June 2010 to June 2016 were admitted to the hospital patients,male 146 cases,female 104 cases,aged 21 to 68 years old,the average(45.5 + 9.5)years of age,the disease course ranged from 6 to 71 h,140 cases were divided into treatment group,110 cases in the control group,patients in experimental group were intraperitoneally with electronic mirror for abdominal exploration,the control group was treated with traditional laparotomy.According to the treatment by laparoscopic and laparotomy two schemes,observed 2 groups of diagnosis rate,incision length,bleeding volume,intubation rate and intubation time,operation time,antibiotic use time,postoperative abdominal pain disappeared time,defecation time,anal exhaust time,hospitalization time difference of feeding,total hospitalization the cost and the rate of incision infection,and evaluate the advantages of analysis,evaluation of laparoscopic examination in the diagnosis and treatment of acute abdomen.The data processing method for SPSS 18 software was used for statistical analysis of the data obtained by standard deviation measurement data(?x ± s),were compared by t test;count data to rate(%),comparison between groups using chi square test 2.P < 0.05 for the difference was statistically significant.Quality control method: all the patients were admitted to hospital with acute abdominal pain,admission had different degrees of abdominal tenderness and rebounding pain and peritoneal irritation,abdominal radiograph and abdominal ultrasound,abdominal CT,urine amylase,abdominal diagnosis puncture were not very clear diagnosis.Exclusion criteria for hemodynamic instability,intra-abdominal hemorrhage,suspected severe compound injury or retroperitoneal organ injury,preoperative non operative means have been clearly diagnosed,laparoscopic surgery was converted to laparotomy.Results A total of 250 cases of acute abdomen patients in our hospital from June 2010 to June 2016 were included: Acute appendicitis and acute episode of chronic appendicitis in 122 cases(48.8%),43 cases of perforation of gastroduodenal ulcer(17.2%),acute cholecystitis and chronic cholecystitis acute attack in 67 cases(26.8%),18 cases of adhesive intestinal obstruction(7.2%)The test group 140 cases were diagnosed by laparoscopy and complete surgery under microscope,1 cases of deaths;110 cases in the control group were treated with traditional laparotomy,two patients diagnosed with no significant difference(P>0.05),but the length of incision,bleeding,catheter indwelling time and rate the operation time,antibiotic use time,postoperative abdominal pain disappeared time,anal exhaust defecation time,eating time,hospitalization rate showed significant differences in total costs and hospitalization time,incision infection(P<0.05).Conclusions(1)The application of laparoscopy in acute abdomen exploration,early diagnosis,and can avoid unnecessary laparotomy,thus avoiding the condition of delay,improve the prognosis of patients;(2)patients with acute abdomen laparoscopic surgery,the diagnosis and treatment simultaneously,both the dual role of diagnosis and treatment;(3)laparoscopy can give full play to the characteristics of laparoscopic vision in the diagnosis and treatment of acute abdomen in operation under direct vision,is conducive to the abdominal cavity pus,blood,bile and intestinal contents were thoroughly washed,then placed in each pit drainage helps,reduce postoperative infection and intestinal adhesions;(4)laparoscopy application in the diagnosis and treatment of acute abdomen caused by small wound,less interference in the abdominal cavity tissue operation under laparoscope on organ damage is lighter,operation After the occurrence of intestinal adhesions,postoperative gastrointestinal function was quickly restored,reducing the length of hospital stay,reducing the cost of hospitalization.