腹腔镜在小肠出血诊治中的临床应用.docVIP

腹腔镜在小肠出血诊治中的临床应用 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：腹腔镜在小肠出血诊治中的临床应用 1 1 资料与方法 2 2 结 果 3 3 讨 论 4 文2：腹腔镜在小肠出血诊治中的临床应用 6 1 资料与方法 7 2 结 果 8 3 讨 论 9 参考文摘引言： 10 原创性声明（模板） 12 文章致谢（模板） 12 正文 腹腔镜在小肠出血诊治中的临床应用 文1：腹腔镜在小肠出血诊治中的临床应用 【Abstract】 Ｏbjective:To evaluate the effect of laparoscopy in diagnosis and treatment for the patients with small intestinal :The clinical data of patients with small intestina1 bleeding underwent laparoscopic diagnosis and treatment from Sep 2003 to in our hospital were retrospectively analyzed with the operative time,blood loss,length of incision,the time for passage of flatus,postoperative hospitalization and operative :All 55 patients were diagnosed and treated by laparoscopic procedure successfully including 7 laparoscopic intestinal local resectio,10 laparoscopic intestinal diverticular resectio,37 laparoscopic partial intestinal resectio and 1 laparoscopic right mean operative time was (±)min,blood loss was (±)m1,length of incision was (±)cm,time for passage of flatus was (±)d and the postoperative hospitalization was (±) patients（%）with operative complicatio occurred with anastomosis bleeding and adhesional intestinal 29（550）months followingup,no recurrent cases were :Laparoscopy is a very useful and minimally invasive technique in the diagnosis and treatment of small intestinal is simple,safe,effective and worthy of be clinically applied. 【Key words】 Laparoscopy；Small intestinal bleeding;Diagnosis 小肠出血通常是指Treitz韧带至回盲瓣之间肠道的出血,约占整个消化道出血的2%～15%［１］,是不明原因消化道出血的主要原因之一。由于发病率低、症状隐匿及小肠本身解剖特点的限制,临床上易漏诊和误诊。常规的胃镜和结肠镜检查是诊断小肠疾病的盲区,随着双气囊小肠镜的问世和腹腔镜技术的广泛应用,越来越多不明原因的小肠出血患者得到了及时准确的诊断和手术 治疗 。近年来,我院应用双气囊小肠镜和腹腔镜对55例小肠出血患者进行了诊断和治疗，现报道如下。 1 资料与方法 临床资料 2003年9月至2007年6月共诊治55例可疑为小肠来源的消化道出血,其中男38例，女17例,平均（±）(13～76）岁,术前平均血红蛋白78(45～110）g/L。 手术方法 所有探查和手术均在全麻下进行。患者取仰卧位,术者位于患者右侧,助手位于患者左侧。先在脐孔穿刺建立气腹(15mm Hg)后,置入10mm Trocar并置入30°腹腔镜,然后于脐孔与剑突中点和右中腹各置入5mm Trocar及无损伤肠钳。依次探查肝脏、胆囊、胃、十二指肠、脾脏、大小网膜、结直肠、盆腔等,然后以曲氏韧带为标志自上而下探查整个空肠和回肠至盲肠,或者以盲