Fernando H C, Alle K M, Chen J, Davis I, Klein S R
Department of Surgery, Harbor/University of California at Los Angeles Medical Center, Torrance 90500.
Br J Surg. 1994 Mar;81(3):384-5. doi: 10.1002/bjs.1800810320.
Laparoscopy was performed on 33 patients with penetrating abdominal injuries to identify those with peritoneal penetration. Diagnostic or therapeutic manoeuvres were not attempted; evidence of peritoneal penetration mandated exploratory laparotomy. Twenty-two patients had gunshot wounds and 11 stab wounds. Ten patients had multiple penetrating injuries. Intraperitoneal injury was not evident by clinical assessment in any patient and all were haemodynamically stable. Twenty-three patients underwent negative laparoscopy and no intraperitoneal injury was subsequently detected. Laparoscopy demonstrated peritoneal penetration in ten patients and subsequent laparotomy detected intraperitoneal injuries in nine. No complications of laparoscopy occurred. In stable patients with penetrating trauma and no clinical evidence of intraperitoneal injury, laparoscopy effectively and safely detects those with peritoneal penetration.
对33例腹部穿透伤患者进行了腹腔镜检查，以确定那些有腹膜穿透的患者。未尝试进行诊断或治疗操作；腹膜穿透的证据要求进行剖腹探查术。22例患者为枪伤，11例为刺伤。10例患者有多处穿透伤。所有患者经临床评估均未发现腹腔内损伤，且血流动力学稳定。23例患者腹腔镜检查结果为阴性，随后未检测到腹腔内损伤。腹腔镜检查显示10例患者有腹膜穿透，随后的剖腹探查术在9例患者中发现了腹腔内损伤。未发生腹腔镜检查的并发症。对于有穿透伤且无腹腔内损伤临床证据的稳定患者，腹腔镜检查能有效且安全地检测出有腹膜穿透的患者。
