腹腔镜在腹部创伤的临床应用

Clinical Application of Laparoscopy in Detection and Treatment of Abdominal Trauma

摘要: 目的：研究腹腔镜技术在腹部创伤中应用的可行性及实用性。方法：回顾性分析我院2012年12月~2015年6月经腹腔镜探查的36例腹部创伤患者临床资料(其中包括全腔镜探查及手辅助腹腔镜探查)，男性32例，女性4例；年龄19~60岁，平均(47.5 ± 12.2)岁。记录手术时间、术中出血量、术后引流量、手术并发症、术后住院天数。结果：36例患者均使用腹腔镜探查明确诊断，其中12例患者行全腔镜探查，24例行手辅助腹腔镜探查，全腔镜组4例中转开腹，8例使用腹腔镜完成治疗，手辅助组在腔镜下完成操作后经辅助切口完成整个手术，手术时间30~210 min，平均110.5 ± 35.6 min。术中出血量60~2000 ml，平均出血815.6 ± 125.4 ml。术后住院5~14 d，平均7.6 ± 2.5 d。结论：合理选择腹腔镜手术方式对腹部创伤患者行腹腔镜探查不仅能够快速明确腹部损伤部位，还能使部分患者在腔镜下完成治疗，且微创优势明显。

Abstract: Objective: To evaluate the feasiblity and practicability of laparoscopy in the detection and treat-ment of abdominal trauma. Methods: The clinical date of 36 cases of abdominal trauma who re-ceived laparoscopic detection and operation in our department from December 2012 to June 2015 were analyzed retrospectively. There were 32 males, 4 females, with an average age of (47.5 ± 12.2) years (ranging from 19 to 60 years old). The operation time, intra-operative bleeding volume, postoperative drainage volume, postoperative complication and postoperative hospital stay were recorded. Results: Total laparoscopic exploration was performed in 12 patients, of whom 4 cases were completed successfully and 8 cases were converted to open procedure. Hand-assisted laparoscopic exploration was performed in 24 cases, all of which were completed under laparoscopy assisted incision operation. The operating time was 30~210 minutes (mean 110.5 ± 35.6 minutes). The intraoperative blood loss was 60~2000 ml (mean 815.6 ± 125.4 ml). The average postoperative hospital stay was 5~14 days (mean 7.6 ± 2.5 days). Conclusion: The appropriate operative procedure is helpful in laparoscopic in detection and treatment of abdominal trauma that not only to make definite position of injury quickly but also to complete surgery successfully which is a mini-invasive treatment.