CAJ | 학술논문

目的：探讨腹腔镜手术在腹部闭合性外伤中的应用效果，并与传统剖腹探查手术方法进行对比分析。方法以2010年9月至2014年11月我院收治的66例闭合性腹部外伤患者为研究对象，其中33例行传统剖腹探查术（剖腹探查组），33例行腹腔镜探查术（腹腔镜探查组）。对比手术时间、术后疼痛持续时间、术后首次排气时间、术后住院时间、住院总费用。结果所有病例中：肝破裂18例，小肠破裂16例，脾破裂15例，肠系膜损伤8例，腹膜后血肿3例，胃破裂2例，腹腔内多脏器损伤4例。剖腹探查组完成手术33例，腹腔镜探查组完成腹腔镜手术28例，中转开腹5例，对比剖腹探查组，手术时间无统计学差异，术后疼痛持续时间、术后首次排气时间、术后住院时间、术后下地活动时间、住院时间及住院总费用均明显降低，差异有统计学意义（ P＜0．05）。所有患者均治愈出院，随访6～12个月无并发症发生。结论腹腔镜手术在闭合性腹部外伤中，可以及时明确诊断，治疗安全、有效。
목적：탐토복강경수술재복부폐합성외상중적응용효과，병여전통부복탐사수술방법진행대비분석。방법이2010년9월지2014년11월아원수치적66례폐합성복부외상환자위연구대상，기중33례행전통부복탐사술（부복탐사조），33례행복강경탐사술（복강경탐사조）。대비수술시간、술후동통지속시간、술후수차배기시간、술후주원시간、주원총비용。결과소유병례중：간파렬18례，소장파렬16례，비파렬15례，장계막손상8례，복막후혈종3례，위파렬2례，복강내다장기손상4례。부복탐사조완성수술33례，복강경탐사조완성복강경수술28례，중전개복5례，대비부복탐사조，수술시간무통계학차이，술후동통지속시간、술후수차배기시간、술후주원시간、술후하지활동시간、주원시간급주원총비용균명현강저，차이유통계학의의（ P＜0．05）。소유환자균치유출원，수방6～12개월무병발증발생。결론 복강경수술재폐합성복부외상중，가이급시명학진단，치료안전、유효。
Objective To investigate the clinical application of laparoscope in Blunt abdominal trauma and make a contrastive analysis on the treatment for laparoscope and abdominal laparotomy.Methods Clinical data of 66 cases of blunt abdominal trauma in our hospital from September 2010 to November 2014 were analyzed, half of which were treated with abdominal laparotomy ( Group AL) while the others were treated with laparoscope ( Group LA) .Then contrasting the operation time, pain duration, first aerofluxus time, hospitalization duration and the total cost of two groups.Results In all the cases there were 18 hepatorrhexis, 16 cases of rupture of small intestine, 15 rupture of spleen, 8 cases of mesentery injury, 3 cases of retroperitoneal hematoma, 2 cases of gastrorrhexis and 4 cases of abdominal visceral injuries.Group AL done all the surgeries successfully while Group LA finished 28 cases with 5 cases conversed to laparotomy.There was no significant difference between the two groups in operation time.Compared with Group AL, Group LA held less pain duration, earlier first aerofluxus time, shorter hospitalization duration and lower total cost, and had significant differences (P<0.05).All the patients were cured with no complications in 6 to 12 months'follow-up.Conclusions The usage of laparoscope in blunt abdominal trauma is useful in making early diagnosis, it is safe and effective.