腹腔镜诊治腹部外伤76例体会

Diagnosis and treatment of abdominal traumas with laparoscopy:Experience with 76 cases

目的探讨腹腔镜在腹部外伤中诊断与治疗的价值。方法自2000年8月至2008年10月,对具有剖腹探查指征的76例腹部外伤病人应用腹腔镜技术进行探查、诊断,并根据腹腔镜探查结果决定和实施腹腔镜下治疗或中转开腹手术。结果经腹腔镜探查76例,全部明确诊断,59例于镜下行治疗性手术,6例无需手术处理,11例中转开腹手术,其中5例为腹腔镜辅助手术。术后无并发症及死亡病例,全组均治愈出院。结论腹腔镜技术应用于腹部外伤具有诊断准确率高、创伤小、安全可靠,并有效降低阴性剖腹探查率等优点,适用于大部分腹部外伤的病例。

Objective To investigate the value of laparoscopy in the diagnosis and treatment of abdominal traumas. Methods From Aug. 2000 to Oct. 2008, we diagnosed and treated 76 cases of abdominal traumas indicated for exploratory laparotomy under laparoscopy. Based on laparoscopic findings,we performed laparoscopic or open surgery accordingly. Results All of the 76 cases were diagnosed by laparoscopy. Fifty-nine cases were treated with laparoscopy,6 cases had no need of surgical treatments, and 11 cases converted to open surgery（including 5 cases subject to laparoscopy-assisted surgery）. No complications and death occurred. All cases had successful recovery after surgery. Conclusion Laparoscopic diagnosis and treatment of abdominal traumas have many advantages, such as high diagnostic accuracy, minimal injury, high safety and reliablity, and reduction in the failure rate of open abdominal explorations.