Velmahos G C, Demetriades D, Stewart M, Cornwell E E, Asensio J, Belzberg H, Berne V
Department of Surgery, University of California, Los Angeles, USA.
J R Coll Surg Edinb. 1998 Aug;43(4):235-8.
There is considerable debate between the proponents of open and closed diagnostic peritoneal lavage (DPL). A prospective study was undertaken on 130 patients submitted to DPL. We performed 55 (42.3%) closed and 75 (57.7%) open lavages with sensitivity and specificity of 100 and 96.6% for the former and 92.2 and 100% for the latter. The mean time for insertion of the catheter and initiation of fluid infusion was significantly less in the closed DPL group, and so were the number of cases with prolonged procedures. No intra-abdominal or wound complications were detected with either method, but there were 10 DPL failures due to inability to conclude the procedure successfully and derive a definite result. Eight of these (10.6%) belonged to the open group and two (3.6%) to the closed (P < 0.05). Our findings suggest closed DPL is as equally sensitive and specific as closed DPL, but is more expeditious and offers inconclusive results less often. Both procedures are useful and should be parts of surgical training.
开放式与封闭式诊断性腹腔灌洗（DPL）的支持者之间存在相当大的争论。对130例行DPL的患者进行了一项前瞻性研究。我们进行了55例（42.3%）封闭式和75例（57.7%）开放式灌洗，前者的敏感性和特异性分别为100%和96.6%，后者为92.2%和100%。封闭式DPL组导管插入和开始输液的平均时间明显更短，操作时间延长的病例数也是如此。两种方法均未检测到腹腔内或伤口并发症，但有10例DPL因无法成功完成操作并得出明确结果而失败。其中8例（10.6%）属于开放组，2例（3.6%）属于封闭组（P<0.05）。我们的研究结果表明，封闭式DPL与开放式DPL同样敏感和特异，但更迅速，得出不确定结果的情况更少。两种操作都很有用，都应成为外科培训的一部分。
