腹腔镜探查在腹部外伤诊治中的应用  

Application of laparoscopic exploration in diagnosis and treatment of abdominal trauma

作　　者：王怀明[1] 折占飞[1] 吴波[1] 张永乐[1] 

机构地区：[1]鄂尔多斯市中心医院东胜部,内蒙古鄂尔多斯017000

出　　处：《腹腔镜外科杂志》2016年第6期468-470,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨腹腔镜技术诊治腹部外伤的应用价值。方法：回顾分析32例腹部外伤患者行腹腔镜探查的临床资料。结果：32例均经腹腔镜探查明确诊断,无漏诊、误诊。26例（81.25%）在腹腔镜下完成手术处理,包括6例脾破裂修补术,3例脾切除术,4例肝破裂修补术,2例结肠破裂修补术,1例结肠造瘘术,4例小肠破裂修补术,2例胃破裂修补术,1例胰体损伤行损伤限制性病损清除引流术,2例肠系膜破裂缝合术,1例腹壁损伤腹膜缝合术。6例（18.75%）伤情较重的患者在腹腔镜指导下中转开腹,1例术后出血二次手术。患者均痊愈出院,无死亡病例。住院3-12 d,平均（7.2±2.88）d。结论：腹腔镜探查诊治腹部外伤具有创伤小、准确性高、并发症少、康复快、死亡率低的优点,较传统剖腹探查术具有显著优势,值得推广应用。Objective： To evaluate the laparoscopy in diagnosis and treatment of abdominal trauma. Methods： Retrospective analysis was done on 32 cases of abdominal trauma explored by laparoscopy. Results： Thirty-two patients were diagnosed by laparoscopic exploration without missed diagnosis or misdiagnosis. In them,26 cases（ 81. 25%） were operated with laparoscopy,including surgical repair of spleen rupture（ n = 6）,3 cases of splenectomy,surgical repair of liver rupture（ n = 4）,surgical repair of colon rupture（ n =2）,1 case of colostomy,surgical repair of small intestinal rupture（ n = 4）,surgical repair of gastric rupture（ n = 2）,injury-restricted lesion-removal drainage for pancreatic injury（ n = 1）,suture of mesentery disruption（ n = 2）,and peritoneum suture for abdominal wall injury（ n = 1）. 6 patients（ 18. 75%） with heavy injury were converted to laparotomy under the guidance of laparoscopy,1 patient with postoperative bleeding was performed a second surgery. All the patients recovered without deaths,and hospitalized for 3 to 12 d with an average of（ 7. 2 ± 2. 88） d. Conclusions： Laparoscopic exploration for the treatment of abdominal trauma has advantages of small trauma,high accuracy,few complications,rapid recovery and low mortality. Compared with conventional laparotomy,laparoscopic exploration has significant advantages and is worthy of promotion.

关 键 词：腹部外伤 腹腔镜检查 诊断 治疗 

分 类 号：R656[医药卫生—外科学]