腹腔镜在腹部外伤诊治中的应用价值分析

目的探讨腹腔镜探查术在急诊腹部外伤诊治中的应用价值。方法回顾性分析我科自2005年8月至2010年10月收治的62例经腹腔镜探查的腹部外伤患者的临床资料。结果62例腹部外伤患者均于镜下作出诊断，诊断准确率100％。46例于镜下完成探查手术（其中探查阴性10例及腹膜后血肿2例未作特殊处理），16例中转开腹手术。手术时间40～180min，平均100min，住院时间3—24d，平均9d。所有患者均治愈，无肠漏、腹腔内大出血、腹腔脓肿等严重并发症。结论腹腔镜探查术应用于急诊腹部外伤具有创伤小、诊断准确率高、恢复快以及诊断和治疗兼顾等优点，可有效地降低阴性剖腹探查率，提高治愈率，值得基层医院广泛推广。

Applied value of laparoscopic diagnosis and treatment for emergency abdominal trauma

Objective To approach the clinical value of laparoscopic diagnosis and treatment for emergency abdominal trauma in the basic level hospital. Method The clinical data of 62 cases of emergency abdominal trauma, who were diagnosed and treated by laparoscopic approach in our department from Aug. 2005 to Oct. 2010 ,were retrospectively analyzed. Results All the 62 cases of emergency abdominal trauma were diagnosed by laparoscopy,and the accuracy rate was 100%. Forty -six cases underwent exploratory operation by laparoscopy （10 cases of negative result and 2 cases of retroperitoneal hematoma, without special handling） ,and 16 cases were converted to open operation. The operation time were between 40 to 180 minutes,and the mean value was 100. The lengths of stay were 3 to 24 days,and the mean value was 9. All cases had successful recovery after surgery without grave complications such as bowel leakage, peritoneal hemorrhea and peritoneal abscess. Conclusion Laparoscopic diagnosis and treatment for abdominal trauma have many advantages such as less trauma, higher diagnosis rate, quicker revival and giving consideration to both diagnosis and treatment, which reduces non - therapeutic laparotomies and raises cure rate. It deserves to be popularized in the basic level hospital.