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1、腹腔镜手术治疗肝脓肿临床分析田小林'王海鹏'朱小宝'余双福2丘继海'(1,桂林医学院附属医院普外一科，541001；2,广西阳朔县富康医院外科，541900；3,广西荔浦县中医院外科,546600)摘要：目的总结腹腔镜手术治疗肝脓肿的方法及临床应用价值。方法釆用腹腔镜手术治疗肝脓肿，分别使用脓肿穿刺、切开、开窗、吸引、冲洗、引流及膈下引流6种术式，总结治疗效果。结果35例全部治愈出院，术后住院7-16d,平均8.5do术后并发胆痿1例，门诊换药2月愈合；脐部感染1例，住院期间治愈。余术后均恢复顺利，腹痛、腹胀、发热
2、于术后l-5d缓解，外周血白细胞4-7d均降至正常。结论腹腔镜手术治疗肝脓肿，手术精确、简单、微创、可采用多种术式，效果好，是治疗肝脓肿的理想方法。关键词腹腔镜手术；治疗；肝脓肿TheclinicalanalysisoftreatingtheliverabscessbyusingLaparoscopicsurgeryTIANXiao-linWANGHai-pengZHUXiao-baoYUShuang-fuQIUJi-hai(Department1ofGeneralSurgury,theAffiliatedhosp
3、italofGuilinMedicalCollege,541001.DepartmentofSurgury,theFuKanghospitalinGuangxiYangshuoCounty,541900.DepartmentofSurgury,thetraditionalChinesemedicalhospitalinGuangxiLipuCounty,546600.)Abstract:ObjectiveTosummarizethemethodandtheclinicalpracticevalueofLaparos
4、copicsurgeryinthetreatmentoftheliverabscess・MethodsUsingtheLaparoscopicsurgerytotreattheliverabscessin6techniquetypes,includingtheabscesspuncturation,theincision,thewindowimg,theattraction,theflushing,thedrainageandthesubdiaphragmaticdrainage,andsummarizingthe
5、treatmentresult.Results35caseswerecuredanddischargedfromhospitalcompletely.Ofthe35patients,thehospitalstayafteroperationwas7-14d(mean,8.5d).Abiliaryfistulahappenedafteroperationandwascuredafter2monthchangedressingsinout-patientclinic,umbilicalpartinfectionhapp
6、enedinacaseandwascuredinhospital.Theresumerecoveredsuccessfullyafteroperation,abdominalpain,abdominaldistentionandfeverwererelievedinl-5dafteroperation,peripheralwhitebloodcellsdroppedtonormalin4・7dafteroperationinallcases.ConclusionThesurgeryusingLaparoscopic
7、surgerytotreattheliverabscessisprecise,simple,microcreates,andmaybeabletousemanykindsoftechniquetypewithexcellenteffect.Itistheidealmethodtotreattheliverabscess.Keywords:Laparoscopicsurgery;Treatment;Liverabscess腹腔镜手术具有微创、精确、美容、术后恢复快等优点，近年来已得到较为广泛的开展⑴,2002年至20
8、08年我们应用腹腔镜手术治疗肝脓肿35例，效果满意，予以报告。1临床资料1.1一般资料本组病例35例，其中男性28例女性7例，平均年龄43.5岁，单发脓肿30例，多发脓肿5例，脓肿总数43个，肝右叶36个，肝左叶6个，脓肿最小7cm,脓肿最大16cm。5例临床表现均有发热、腹痛、腹胀、白细胞升高，经B超、CT诊断，所有病例均为细菌性肝脓肿。其中有3例经B超穿
