腹腔镜诊治开放性腹部刀刺伤的应用与体会  

Application and experience of the laparoscopic diagnosis and treatment of abdominal open stab injury

作　　者：尹高平[1] 王军力[1] 曲茂茂 

机构地区：[1]滨州医学院烟台附属医院,山东烟台264100

出　　处：《腹腔镜外科杂志》2015年第9期705-707,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜在腹部开放性刀刺伤诊治中的应用及优势。方法:2008年5月至2015年1月收治41例确诊为开放性刀刺伤患者,采用腹腔镜进行诊治,首先于腔镜下进行诊断,明确诊断后,部分患者于镜下直接进行治疗,部分患者在腔镜指导下行小切口开腹手术治疗。结果:患者均于腹腔镜下明确诊断,其中小肠破裂22例,肠系膜破裂5例,肝破裂5例,胃破裂3例,结肠破裂2例,阴性探查4例。30例直接在腹腔镜下进行治疗,3例在腹腔镜指导下行小切口开腹手术治疗,4例中转开腹治疗,4例阴性探查避免了传统手术创伤。术后均未出现并发症,腹腔镜手术治疗的患者病情恢复及精神状态均好于同期开腹手术患者,均痊愈出院。结论:腹腔镜在开放性腹部刀刺伤中具有诊断与治疗的双重功效,既可明确诊断,又可最大程度地减少手术创伤,手术安全、可靠,优势显而易见,值得推广应用。Objective： To discuss the application and advantages of laparoscopy in the diagnosis and treatment of abdominal open stab injury. Methods： From May 2008 to Jan. 2015,41 patients with abdominal open stab injury underwent laparoscopic operations,the definite diagnosis was firstly made,then laparoscopic operations or the small-incision laparotomy under the guidance of laparoscopy was applied. Results： Diagnosis were confirmed by laparoscopy in all the cases. Among these cases,there were 22 cases of small intestine rupture,5 cases of mesentery disruption,5 cases of hepatic rupture,3 cases of gastric rupture,2 cases of colon rupture,4 cases of negative detection. In the process of treatment,30 cases underwent laparoscopic surgery,3 cases received small-incision laparotomy under the guidance of laparoscopy,and 4 cases were converted to open surgery,the 4 negative detection cases avoided the traditional surgical trauma. No postoperative complications were found. And in the recovery process,both the disease recovery and mental state of patients with laparoscopy were better than those with laparotomy. All the patients healed and were discharged from hospital. Conclusions： Laparoscopy for the abdominal open stab injury has dual efficacy of diagnosis and treatment. Laparoscopy can not only make the definite diagnosis,but also minimize the surgical trauma with obvious advantage,it is safe,reliable,and worth popularization in clinical work.

关 键 词：腹部刀刺伤 开放性 腹腔镜检查 诊断 治疗结果 

分 类 号：R656.1[医药卫生—急诊医学]