腹腔镜技术诊治闭合性腹部创伤39例临床分析

Laparoscopic detection and treatment of closed abdominal trauma in 39 cases

目的探讨闭合性腹部创伤中腹腔镜技术的临床应用价值。方法回顾分析应用电视腹腔镜技术诊治39例闭合性腹部创伤患者的临床资料。结果39例伤者均在腹腔镜下明确诊断。35例在腹腔镜下或腹腔镜辅助下手术处理损伤,取代治疗性剖腹手术,术后恢复快且佳;4例中转剖腹手术,恢复顺利。上述伤者均未发生手术并发症,痊愈出院。结论腹腔镜技术诊治闭合性腹部创伤,可明确诊断,避免阴性剖腹探查手术;可腹腔镜下或腹腔镜辅助下手术处理损伤,取代治疗性剖腹手术;还能指导剖腹手术的切口选择及术式;并具有创伤小,术后恢复快的特点。只要应用得当,就能使病人以最小的创伤获得最佳的诊治效果,适合基层医院开展。

Objective To study the clinical value of laparoscopy in the detection and treatment of closed abdominal trauma. Methods A retrospective analysis was conducted in 39 patients with closed abdominal trauma detected and treated laparo-scopically. Results All the injuries were successfully diagnosed with laparoscopy, and surgical treatment was performed un-der laparoscope or with the assistance of laparoscopy in 35 cases, with the other 4 cases requiring conventional laparotomy. All the patients recovered smoothly without operative complications. Conclusions Laparoscopy may reach definite diagnosis with avoidance of negative exploratory laparotomy, and laparoscopic surgery is possible to replace conventional therapeutic laparotomy for these injuries. With minimum invasion and small incisions, laparoscopy facilitates rapid postoperative recovery at the minimal risk of operative injuries.