腹腔镜在腹部外伤诊断及治疗中的应用

目的 探讨腹腔镜在腹部外伤诊断与治疗中的价值.方法 回顾分析2008年1月～2010年12月因腹部外伤选择腹腔镜探查进行诊断和治疗的38例患者的临床资料.结果 38例均采用腹腔镜探查确诊,诊断为肝破裂8例、小肠破裂7例、脾破裂6例、大网膜血管破裂出血4例、腹壁损伤4例、腹膜后血肿3例、肠系膜血管破裂出血3例、胰腺损伤2例、膈肌穿孔1例.腹腔镜下完成手术19例,未行特殊处理7例,中转开腹手术12例.38例均治愈出院,住院时间5～15 d,其中26例在腹腔镜下治疗者,术后1～3 d排气,住院5～8 d,无并发症发生.结论 腹腔镜探查是集诊断和治疗于一体的一项微创外科技术,具有安全、准确、术后并发症少、恢复快等优点,可应用于腹部外伤的诊疗.

Laparoscopy in Diagnosis and Treatment of Acute Abdominal Trauma

Objective To explore the experiences and values of laparoscopy in abdominal injuries. Methods Clinical data of 38 patients with abdominal injuries undergoing laparoscopic exploration during January 2008 and December 2010 were retrospectively analyzed. Results 38 patients were diagnosed by laparoseopic exploration, 8 of whom were diagnosed with hepatorrhexis, 7 with rupture of small intestines, 6 with rupture of spleens, 4 with rupture of epip- loon haemorrhages, 4 with injury of abdominal walls, 3 with retroperitoneal hematomas, 3 with rupture of mesenterie vessel haemorrhages, 2 with injury of pancreas, 1 with rupture of diaphragm. 19 patients were operated on under celioscope, 7 patients had no need of surgical treatmeat, 12 patients were converted to open abdomen surgery. All the patients were cured, and the mean hospitalization time was 5-15 days, and no complications occurred. Conclusion Laparoscopic exploration in abdominal injuries as a minimally invasive surgical technique has many advantages such as safety, accuracy, easy diagnosis and treatment, short-term recovery and few complications.