口服多潘立酮片提高术前超声检查对腹腔胆囊切除术第一戳孔部位选择的探讨

目的探讨口服多潘立酮片提高术前超声检查对腹腔胆囊切除术第一戳孔部位选择的临床应用价值。 方法患者晨空腹，在实施超声检查前30min，口服多潘立酮片10mg，于30min后饮水300～400ml，待15min，患者取平卧位，嗣后实施超声检查，探头置于脐孔周围边缘，嘱患者深呼运动，观察肠管与腹壁层、腹膜间有无滑动征，确定有无粘连。 结果310例腹腔镜胆囊切除术（laparoscopic cholecystectomy，LC），术前经超声检查与LC进镜手术对照，腹腔粘连第一戳孔位置，超声检出率98．7％（306／310）。310例中轻度粘连169例（54．5％），中度粘连129例（41．6％），重度粘连12例（3．9％）。 结论术前超声检查腹腔粘连，可为正确选择第一戳孔位置提供粘连部位、大小、形态、范围及程度等信息，图像清晰，具有推广应用价值。

Oral Domperidon Assessment for Improving Accurate Selection of the First Trocar Insertion Position During Ultrasonic Diagnosis Before Laparoscopic Cholecystectomy

Objective To evaluate the oral Domperidon tablets for ultrasound-guided accurate selection of the first trocar insertion position before laparoscopic choleystectomy(LC).Methods In the morning,patients in fast condition,orally took 10 mg Domperidon tablets 30 min before sonography,drank 300-400 ml water,and lay on the back after 15 min.The transducer was put around the umbilical edge.The patients were asked to do deep breath for observing the enteric loops and the abdominal wall to make sure whether there was the sliding phenomenon(the adhesion sign)present.Results All the 310 cases before LC underwent ultrasonography the results of which were compared with those of laparoscopy.We found the unltrasonic diagnosis rate of adhesion in the first trocar insertion position was 98.7%(306/310),In 310 cases slight adhesion was in 169 cases(54.5%),moderate was in 129(41.6%) and serious was 3.9%(12/310).Conclusions The ultrasonic diagnosis of the adhesion before LC is helpful for selecting the first trocar insertion,and may provide the position,size,patterns,range and severity degree of the adhesions.This method is simple,pain-free,scar-free,with distinct images and cheap in price,therefore it is worthy to be used widely in clinical.