腹腔镜技术在腹部闭合性损伤中的应用

Laparoscopic techniques in the treatment of blunt abdominal trauma

目的探讨腹腔镜技术在腹部闭合性损伤的治疗中的应用效果。方法选取2015年1月至2015年5月收治的闭合性腹部损伤患者86例,根据治疗方式分为腹腔镜手术组(64例)和中转开腹手术组(22例)。采用SPSS 20.0进行分析处理,术后并发症发生率采用χ2检验;手术时间、术中出血量、住院时间和住院费用采用(x珋±s)表示并行t检验。以P<0.05为差异有统计学意义。结果腹腔镜手术组手术时间、术中出血量、住院时间、住院费用均显著低于中转开腹手术组(t=6.531,t=2.378,t=2.356,t=8.569,P<0.05或P<0.01)。腹腔镜手术组术后并发症发生率3.13%(2/64)显著低于中转开腹手术组36.36%(8/22)(χ2=9.565,P<0.01);出院时,腹腔镜手术组生活质量各维度显著高于中转开腹手术组(t=2.311,t=2.265,t=2.253,t=2.297,P<0.05)。结论对于符合腹腔镜手术适应证的腹部闭合性损伤患者,积极开展腹腔镜手术,具有手术时间短,出血量少、住院相关费低的优势,应严格控制中转开腹率,提高其应用率。

Objective To investigate the clinical outcomes of laparoscopic technique in treatment of blunt abdominal trauma. Methods 86 patients with blunt abdominal trauma treated from January 2015 to May 2015 in our hospital were divided into a laparoscopic surgery group （64 patients） and a conversion to open operation group （22）. Data analysis was performed using SPSS 20. 0 software. The incidence of postoperative complications was examined using the Chi-square test. Operation time, bleeding volume, hospital stay, and medical cost were expressed as mean ＋ SD and examined by Student＇ s t test. P 〈 0.05 was considered statistically significant. Results The operation time, bleeding volume, hospital stay, and hospita cost in the laparoseopie surgery group were significantly lower than those in the conversion to open operation group （ t = 6. 531, t = 2. 378, t = 2. 356, t = 8. 569 respectively; P 〈 0. 05 or P 〈 0.01 ）. The post- operative complication occurrence rate was 3.13% （2/64） in the laparoscopic surgery group, which was sig- nificantly lower than 36.36% （8/22）in the conversion to open operation group （2 = 9. 565, P 〈 0.01 ）. The quality of life of patients in the laparoscopic surgery group was significantly higher than that of the conversion to open operation group （t =2. 311, t =2. 265, t =2. 253, t =2. 297 respectively; P 〈0.05）. Conclusion For patients with blunt abdominal trauma , laparoscopic surgery is indicated. This operation is characterized by shorter operation time, less bleeding volume, short hospital stay, and low cost. But the rate of conversion to open operation should be strictly controlled.