腹腔镜与开腹手术治疗创伤性脾损伤85例对比分析

doi:10.3969/j.issn.1002-1949.2018.08.005

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摘要目的探讨腹腔镜技术在创伤性脾损伤救治中的价值与局限性。方法回顾了2007-04~2018-01西南医院急救创伤中心收治的85例因创伤性脾损伤行传统开腹手术或腹腔镜手术治疗的病例。结果 85例病例中，开腹手术47例，腹腔镜手术38例。腹腔镜组患者机械通气时间、肛门排气恢复时间、ICU住院时间、总住院时间以及术后疼痛评分均低于开腹组。腹腔镜组保脾率显著高于开腹组。腹腔镜组手术时间较开腹组长。两组均无死亡病例以及因脾脏手术导致的非计划二次手术，两组间总体术中出血量以及围术期并发症率差异无统计学意义。结论腹腔镜用于创伤性脾损伤的治疗具有创伤小、恢复快、保脾率高、操作安全、能有效缩短ICU及总体住院时间等特点，适合应用于血流动力学稳定的创伤性脾损伤的治疗。但该技术对术者能力及团队配合要求较高，在遇到困难病例时，不应盲目追求“全腔镜下”手术，必要的中转开腹可以避免病情延误，减少严重并发症的发生。

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	陈翔宇
	谢斌
	邓文君
	谢百发
	周春荣
	马建
	邹龙
	刘明华

关键词 ：创伤性脾损伤, 腹腔镜, 治疗

通讯作者: 刘明华（1965-），男，博士，主任医师，教授， E-mail：mhliu4cq@aliyun.com。

作者简介: 陈翔宇（1977-），男，外科学硕士，副主任医师，E-mail：xiangyuc@hotmail.com。

引用本文:

陈翔宇，谢斌，邓文君，谢百发，周春荣，马建，邹龙，刘明华. 腹腔镜与开腹手术治疗创伤性脾损伤85例对比分析[J]. 中国急救医学, 2018, 38(8): 668-671.
Chen Xiang-yu, Xie Bin, Deng Wen-jun, Xie Bai-fa, Zhou Chun-rong, Ma Jian, Zou Long, Liu Ming-hua. The role of laparoscopy in the management of traumatic splenic injury. Chinese Journal of Critical Care Medicine, 2018, 38(8): 668-671.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2018.08.005 或 http://www.cnemergency.org.cn/CN/Y2018/V38/I8/668

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