腹腔镜在腹部创伤中的作用

Wafa Ala, E. Mustafa, Friwan Rawad, Baio Abdulaziz
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引用次数: 1

摘要

背景:在过去的几年里,腹腔镜在腹部创伤的诊断和治疗干预方面的作用有所增加。它是一种可行的替代诊断腹内损伤在穿透性和钝性创伤。在创伤患者中应用腹腔镜手术后,阴性剖腹手术的数量有所下降。方法:回顾性分析2017年1月至2019年3月半岛医院普外科腹腔镜下腹部创伤患者28例(穿透性创伤22例,钝性创伤6例)。所有患者都进行了临床评估和快速扫描,20例患者进行了ct扫描,8例患者无法进行ct扫描。所有参与研究的患者血压都稳定正常。结果:本组28例腹部外伤患者中,穿透伤22例(78.57%)均为猎枪伤,钝性伤6例(21.43%)。在穿透性创伤中,治疗性腹腔镜7例(31.8%),诊断性腹腔镜10例(45.5%),阴性腹腔镜5例(22.7%)。钝性创伤中治疗性腹腔镜2例(33.3%),诊断性腹腔镜3例(50%),阴性腹腔镜1例(16.7%)。对于穿透性和钝性创伤,转行剖腹手术的发生率为8例(28.5%)。结论:对血流动力学稳定的腹部外伤患者进行腹腔镜检查,无论是诊断还是治疗都是安全的;它还有助于减少非治疗性剖腹手术的数量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Role of Laparoscopy in Abdominal Trauma
Background: The role of laparoscopy in abdominal trauma has increased in the last years in diagnosis as well as therapeutic interventions. It is a viable alternative for the diagnosis of intra-abdominal injury in both penetrating and blunt trauma. The number of negative laparotomies decreased since the use of laparoscopy in trauma patients. Methods: A retrospective study of twenty eight patients with abdominal trauma (22 penetrating trauma, 6 blunt trauma) were laparoscopic intervention done by general surgery department at Aljazeera Hospital for Orthopedic and Specialized Surgery from January 2017 to March 2019. All patients underwent clinical assessment and FAST-Scan, CT-scan done for twenty patients and unavailable for eight patients. All of the patients included for the research were stable with normal blood pressure. Results: In our series twenty-eight patients with abdominal trauma, 22 penetrating trauma (78.57%) all were shotgun injuries, and 6 blunt trauma (21.43%). In penetrating trauma therapeutic laparoscopy for seven patients (31.8%), diagnostic laparoscopy for 10 patients (45.5%), and negative laparoscopy for 5 cases (22.7%). In blunt trauma therapeutic laparoscopy for 2 cases (33.3%), diagnostic laparoscopy for 3 cases (50%), and negative laparoscopy for 1 case (16.7%). The rate of conversion to laparotomies was 8 cases (28.5%) for both penetrating and blunt trauma. Conclusion: Laparoscopy can be safely performed in hemodynamically stable patients with abdominal trauma for both diagnostic and therapeutic purposes; also it helps to cut down the number of non-therapeutic laparotomies.
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