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目的 分析现代腹腔镜外科技术对腹部外伤、急腹症诊断和完成一定治疗的指征及效果,指导临床。方法 通过对广州地区4家大型医院腹腔镜在109例腹部外伤、急腹症中的应用情况调查、研究,观察腹腔镜外科技术对小肠穿孔、肝、脾浅表性挫裂伤、肠系膜小血管撕裂伤及后腹膜血肿等诊断及处理情况。结果 109例病人经B起、腹穿及有关实验室检查均有剖腹探察指征,腹腔镜检查结果有胃十二指肠穿孔、小肠穿孔,肝、脾浅表性挫裂伤,肠系膜小血管撕裂伤,后腹膜血肿等。开腹20例,89例(81.7％)免除剖腹探察手术,未开腹者均治愈无并发症。结论 认为行外科腹腔镜诊断检查,能克除部分病人因剖腹探察而无手术治疗指征时的痛苦,能为腹部外伤、急腹症的进一步治疗提供依据。
Objective To analyze the indications and effects of modern laparoscopic surgery on the diagnosis of abdominal trauma and acute abdomen and some treatment to guide the clinical practice. Methods A total of 109 cases of abdomen trauma and acute abdomen were investigated by laparoscopy in 4 large hospitals in Guangzhou. The effects of laparoscopic surgery on perforation of small intestine, superficial laceration of liver and spleen, Laceration and retroperitoneal hematoma diagnosis and treatment. Results 109 patients had laparotomy indications for laparotomy, abdominal perforation and related laboratory tests. Gastro-duodenal perforation, perforation of small intestine, superficial laceration of liver and spleen laparotomy, laparoscopic small blood vessels of mesentery Laceration, retroperitoneal hematoma and so on. Twenty patients underwent open laparotomy and 89 patients (81.7%) underwent laparotomy without complications. Conclusions The laparoscopic diagnosis of surgical laparoscopy can eliminate the pain of some patients due to exploratory laparotomy without surgical indications and provide the basis for further treatment of abdominal trauma and acute abdomen.