经腹腔镜治疗创伤性小肠破裂的初步探索.pdfVIP

中国医药2013 年6 月第8 卷第6 期 China Medicine. June 2013. Vol. 8. No儿 6 .813 . .论著· 经腹腔镜治疗创伤性小肠破裂的初步探索 孙海东魏茂提穆霄燕马程王萌高恩香 [摘要] 目的 初步探讨腹腔镜在治疗创伤性小肠破裂的优势及应用价值。方法 选定我院2010 年 7 月至2012 年7 月间创伤性小肠破裂患者25 例。根据术前腹部 CT、影色多普勒超声检查明确诊断并确定 适应证，以腹腔肠系膜水肿、小肠间可见明显游离气体影及超声多普勒超声评估腹腔游离液体运4∞ d 的病 例作为腹腔镜组(8 例) ，并选择同期开腹手术病例作为传统开腹组(17 例)。观察并比较 2 组患者手术时 间、首次排气时间及切口感染率等指标。结果 腹腔镜组患者治疗后首次排气时间明显少于传统开腹组 [ (2. ∞:t 0.26) d 比(2.94 土 O. 18 闷， P O. 01] 。腹腔镜组和传统开腹组患者手术时间分别为( 133. 1 :t 3.0) 、(1 31. 8 :t 1. 9)min ，组间差异无统计学意义(P O. 05) 。腹腔镜组患者手术切口感染率明显少于传统 开腹组[0 比47.1% (8/17) ,P 0. 05] 。结论 在术前正确诊断的前提下，采用腹腔镜治疗创伤性小肠破裂 方法可行。 [关键词] 腹腔镜; 小肠破裂; 创伤; 微创 [中固分类号] R 656. 7 [文献标识码] A Primary study on laparoscopic treatment of traumatic intes出时 ruput町e SUN Hω， -dong , WEI Mω， -ti ， MUXiω-yan ， MA Che晖，阳NG Meng , GAO En伺ng. •Department 0/ Emerge町，~庐:liated Hω， :pital 0/Lo伊tic College 0/ Chinese People s Armed Police Forces , Tianjin 3ω162 ， China Corresponding aω加r: SUN Hai-dong , Email: sIulO2@163.com [ Abstract ] 0时ective To explore the application of laparoscopic tre础ment of traumatic 则由tinal rupture. Methods All 25 patients suffered from traumatic intestinal ruputure were selected. Diagnosis was performed using abdominal CT and color Doppler; the operation indication criteria included edema of celiaco-mesenteric , visible free gas shadow in 出e inte18pace of small intestine , free liquid with volume less than 4∞ ml in the abdominal cavity be- fore operation. Eight patients in the operation we陀 treated using laparoscopic skill which met the indication criteria and 17 control patients were treated using the ordinary operations which needed the incision of the abdomen.ηle op- eration time , the fi18t fa眈 time and the infection rate caused by the operation were observed and compared between two gro