Abstract
Objective To analyze the application of laparoscopic approach in the diagnosis and treatment of abdominal trauma( AT). Methods The clinical data of 50 AT patients( types,causes,sites of injuries,erect abdominal plain films or CT results)in Xiaolan Hospital Affiliated to Southern Medical University from June 2007 to June 2013 were analyzed retrospec-tively and described statistically. ResUlts Types of AT:45 cases of blunt trauma ( 90. 0%), 5 open sharp injuries (10. 0%). The causes of injuries:29 cases of traffic accident(58. 0%),9 falls injuries(18. 0%),5 stabbing injuries (10. 0%),3 stick-beating injuries(6. 0%),2 weight-crushing injuries(4. 0%),2 fist injuries(4. 0%). Sites of AT:5 cases of simple abdominal wall injuries(10. 0%),5 omentum hematoma(10. 0%),5 mesenteric hematoma(10. 0%),5 liver laceration(10. 0%),12 spleen laceration(24. 0%),2 renal laceration(4. 0%),10 small bowel(20. 0%),1 duo-denal rupture ( 2. 0%),2 stomach rupture ( 4. 0%),1 stomach rupture combined with hepatic left lateral linear laceration (2. 0%),1 right liver laceration complicated by rupture of gallbladder(2. 0%),3 colon rupture(6. 0%),1 pancreatic inju-ry(2. 0%),1 bladder injury(2. 0%),1 rupture of diaphragm combined with liver laceration(2. 0%),1 retroperitoneal he-matoma(2. 0%). Four patients had 2 organic damages(8. 0%),1 had 3 or more(2. 0%). Erect abdominal plain films showed 8 cases of peritoneal cavity free air,account for 47. 1% of the 17 cases of viscus rupture;CT showed 30 cases of hemato-ma,substantial organ damages,accounting for 91. 0% of substantial viscus rupture(33 cases). Fifty patients were diagnosed by laparoscopy(100. 0%),38 patients completed surgeries under laparoscopy or with its help(76. 0%),12 converted to lap-arotomy(24. 0%);the operation time was 35 to 200 min,averagely(65. 0 ± 15. 0)min;blood loss was 10 to 600 ml,mean-ly(100. 0 ± 35. 0)ml;hospital stay was 3 to 25 d,averagely(7. 0 ± 1. 5)d. One patient had ankylenteron obstruction,1 had rehaemorrhagia,1 had wound infection,1 had pelvic abscess,who were all cured after conservative treatment and dis-charged ultimately,without such severe complications as abdominal bleeding,gastrointestinal fistula,multiple organ dysfunc-tion,etc. or perioperative mortality. ConclUsion Laparoscopy makes a high diagnostic rate for AT,can reduce secondary dam-ages and negative probes. But physicians should follow appropriate principles in indications,contraindications,conversion to laparotomy,etc.关键词
腹部损伤/破裂/出血/腹腔镜检查/治疗Key words
Abdominal trauma/Rupture/Hemorrhage/Laparoscopy/Therapy分类
医药卫生
