外伤性直肠破裂的微创治疗  

Minimally invasive therapy of traumatic rectal rupture

作　　者：刘颖涵 关国欣[1] 柳兴铭 刘亚庆 m.Sayyaf.A.H 马莹 张文俊 曲明阳[1] 罗福文[1] LIU Yinghan;GUAN Guoxin;LIU Xingming;LIU Yaqing;m.Sayyaf.A.H;MA Ying;ZHANG Wenjun;QV Mingyang;LUO Fuwen(Department of Acute Abdomen Surgery,the Second Affiliated Hospital of Dalian Medical University,Dalian,Liaoning,116027,China)

机构地区：[1]大连医科大学附属第二医院急腹症外科,辽宁大连116027

出　　处：《临床急诊杂志》2022年第12期812-815,共4页Journal of Clinical Emergency

摘　　要：目的:对比分析腹腔镜手术和开腹手术治疗外伤直肠破裂的疗效。方法:回顾性总结我院2015年1月1日—2022年6月20日收治的外伤直肠破裂患者共54例,其中49例行手术治疗,18例行腹腔镜手术(腹腔镜组),31例行开腹手术(开腹组)。对比2组患者手术情况、术后一般情况、住院总费用和术后并发症的发生率。结果:腹腔镜组的手术时间、术中出血量、住院时间及术后疼痛评分均显著小于开腹组,差异有统计学意义(P<0.05)。腹腔镜组术后并发症发生率为38.9%,开腹组为55.1%,腹腔镜组出现并发症的例数较开腹组少,但差异无统计学意义。结论:及时正确的诊断和早期有效手术对治疗直肠破裂至关重要;腹腔镜手术治疗外伤直肠破裂创伤小,探查全面,手术时间短,术后恢复快,并发症发生率低,且费用方面与开腹手术相差不大,适合临床推广应用。Objective: To compare the efficacy of laparoscopic surgery and open surgery in the treatment of traumatic rectal rupture. Methods: A total of 54 patients with traumatic rectal rupture in our hospital from January 1 st 2015 to June 20 th 2022 were selected, 49 of whom underwent surgical treatment. Eighteen patients underwent laparoscopic surgery(laparoscopic group), and 31 patients underwent open surgery(open group). The operation conditions, postoperative general conditions, total hospitalization costs and incidence of postoperative complications were compared between the two groups. Results: The operation time, intraoperative blood loss, hospital stay, and postoperative pain score of the laparoscopic group were significantly lower than those of the open group(P<0.05). The incidence of postoperative complications was 38.9% in the laparoscopic group and 55.1% in the open group. The number of complications in the laparoscopic group was less than that in the open group, but there was no significant statistical difference. Conclusion: Correct diagnosis and early effective surgery is crucial for the treatment of rectal rupture. Laparoscopic surgery for traumatic rectal rupture has the advantages of less trauma, comprehensive exploration, short operation time, quick postoperative recovery and low complication rate. And there is no significant difference in cost between laparoscopic surgery and open surgery, the use of laparoscopic technology in the treatment of traumatic rectal rupture is worthy of clinical application.

关 键 词：腹腔镜 微创 直肠破裂 外伤 

分 类 号：R657.1[医药卫生—外科学]