腹腔镜在腹部开放性损伤中的应用体会

目的总结腹腔镜外科技术应用在腹部开放性损伤的诊断和治疗的经验。方法应用腹腔镜外科技术对10例腹部刀刺伤的诊断和治疗进行回顾性分析。结果10例病人术前检查均为腹壁穿透伤，腹腔镜检查结果有胃、小肠裂伤、穿孔。腹腔镜检查结果有胃、小肠裂伤、穿孔，肠系膜小血管裂伤，肋间动脉破裂，脾破裂等。2例经腹腔镜探查无阳性发现．7例在腹腔镜下手术治疗．中转开腹1例。均无并发症治愈出院。结论应用于现代腹腔镜技术对腹部开放性损伤进行诊断、治疗具有避免阴性剖腹探查。尽早明确诊断。大部分病人可通过腹腔镜手术治愈从而减少创伤的优点，值得临床推广应用。

Experience in the application of laparoscope for open abdominal injury

Objective To summarize the experience in using laparoscope for the diagnosis and treatment of the open abdominal injury. Methods Form June 2002 to January 2004, 10 cases with abdominal stab wound used laparoscope to perform the diagnosis and treatment were analyzed retrospectively. Result Preoperative examination were penetrating wound of abdiminal wall in 10 cases. The results of laparoscopy were gastric, small intestinal laceration or perforation,laceration of blood vessels,rupture of intercostal artery and spleen etc.Laparoscopic exploration was negative in 2 cases.There was positive findings by laparoscopy in 8 cases.Among them, 7 cases underwent operative treatment under laparoscope. 1 cases was transferred to open abdominal operation.All cases were cured to discharge from hospital.No postoperative complications were found.Conclusion Using laparoscope to diagnose and treat the open abdominal injury, it can avoid negative exploratory laparotomy and can make a determined diagnosis in time.Most of patients can be cured by laparoscopic operation.