基层医院急诊腹腔镜在腹部外伤中的应用体会

目的:探讨急诊腹腔镜手术诊治腹部外伤的有效性。方法:2011年1月至2016年8月应用急诊腹腔镜诊治腹部创伤患者187例,并与同期186例传统剖腹探查病例进行对比,分析急诊腹腔镜在腹部创伤诊治中的及时性、诊断率、治疗率、非治疗性手术率等。结果:腔镜组187例均在腹腔镜下明确诊断或治疗,诊断率100%,139例(74.3%)在腹腔镜下完成治疗,16例(8.6%)未发现明显病灶无需处理,32例(17.1%)中转开腹。术后肠鸣音恢复时间平均(2.5±0.9)d,较剖腹组(3.5±1.4)d]短(P0.05)。未发生腹腔镜相关并发症。结论:急诊腹腔镜诊治腹部损伤安全、可行,可及时做出正确诊断并予以治疗,提高抢救时效,加快康复。

The aplication of emergency laparoscopy for abdominal trauma in primary hospital

Objective:To explore the efficacy of emergency laparoscopy in the diagnosis and treatment of abdominal trauma.Methods:A total of 187 abdominal trauma patients underwent emergency laparoscopic diagnosis and treatment from Jan.2011 to Aug.2016 and their clinical data were compared with those of 186 patients who underwent traditional operation during the same period.The technical timeliness,diagnostic rate,treatment rate and negative exploration rate of emergency laparoscopy were analyzed.Results:All of the 187 patients underwent laparoscopic diagnosis or treatment.All the patients were diagnosed by laparoscopy,139 (74.3%) patients were treated by laparoscopy,32 patients (17.71%) were converted to open operation and no obvious lesions were found in 16 patients (8.6%).The time of bowel sound recovery after operation in laparoscopic group was (2.5±0.9) d and was significantly shorter than that of traditional operation group (3.5±1.4) d,P<0.05].No complications associated with laparoscopy occurred in any patients.Conclusions:Emergency laparoscopy is safe and feasible in the timely diagnosis and synchronal treatment of abdominal trauma,can improve rescue timeliness and accelerate patients' recovery.