腹腔镜技术在诊治腹部穿透伤中的应用评价

Laparoscopic surgery for penetrating abdominal trauma

目的:本研究通过分析我院应用腹腔镜技术诊断和治疗腹部穿透伤病人的具体资料,探讨腹腔镜技术在诊治腹部穿透伤中的应用价值。方法:2007年1月至2010年12月,我院收治的腹部穿透伤142例病人中,39例采用非手术治疗,86例采用腹腔镜探查手术,17例采用开腹探查手术。结果:在86例采用腹腔镜探查手术的病例中,51例在腹腔镜下完成止血、修补等治疗;19例因出血迅猛、腹腔污染严重及病变难以处理而中转开腹手术;16例探查阴性。结论:腹腔镜技术在腹部穿透伤的处理中兼具诊断和治疗的作用,避免了一些不必要的开腹手术,从而取代了很多开腹手术;有创伤小,恢复快等优势,有一定的应用价值。

Objective To evaluate the role of laparoscopy in the management of patients with penetrating abdominal injuries.Methods Data were collected concerning 142 patients who had penetrating abdominal trauma and were admitted into our hospital between Jan 2007 and Dec 2010.According to the characteristics of their abdominal injuries,management was either conservative（39 cases）,immediate laparotomy（17 cases）,or explorative laparoscopic surgery（86 cases）.Results All the 86 cases in the laparoscopy group were diagnosed successfully.Fifty-one of the 86 cases in the laparoscopy group completed all the therapeutic measures during laparoscopy such as hemostasis and repair,19 of them converted to open surgery because of serious bleeding or contamination in the abdominal cavity;while 16 cases had negative findings in laparoscopic surgery.Conclusions Laparoscopic technology is particularly valuable both for diagnosis and treatment in penetrating abdominal injuries.Increased use of laparoscopic surgery for penetrating abdominal injuries will decrease the rate of negative and nontherapeutic laparotomies,thus lowering morbidity and decreasing length of hospitalization.