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目的:评价腹腔镜在小肠出血诊治中的临床应用价值。方法:回顾性分析2003年9月至2007年6月行腹腔镜诊治的55例小肠出血患者的临床资料,并对手术时间、术中失血、切口长度、术后排气时间、术后住院天数、并发症、术后病理和随访结果进行统计学分析。结果:腹腔镜探查不仅明确了所有患者小肠出血的原因,而且同时实施了相应的腹腔镜手术,其中包括7例完全腹腔镜下小肠肿瘤局部切除术;10例腹腔镜下小肠憩室切除术;37例腹腔镜辅助下小肠肠段切除术;1例腹腔镜辅助下右半结肠切除术。腹腔镜平均手术时间(70.0±28.6)min,术中平均失血(13.5±10.2)ml,平均切口长度(3.4±1.3)cm,平均术后排气时间为(2.2±0.8)d,术后平均住院(7.8±2.9)d。2例(3.6%)术后分别出现吻合口糜烂出血和束带粘连性小肠梗阻。术后随访29(5~50)个月,无复发病例。结论:腹腔镜技术在小肠出血诊治中具有良好效果,腹腔镜小肠手术是一种安全、有效的微创手术方法,值得临床推广应用。
Objective: To evaluate the clinical value of laparoscopy in the diagnosis and treatment of intestinal bleeding. Methods: The clinical data of 55 patients with small intestinal hemorrhage diagnosed and treated by laparoscopy from September 2003 to June 2007 were analyzed retrospectively. The operative time, intraoperative blood loss, incision length, postoperative exhaust time, postoperative hospital stay , Complications, postoperative pathology and follow-up results were statistically analyzed. Results: Laparoscopy not only identified the cause of intestinal bleeding in all patients, but also performed the corresponding laparoscopic surgery, including 7 cases of complete laparoscopic partial resection of small intestine tumor; 10 cases of laparoscopic diverticulum diverticulum; 37 Cases of laparoscopic assisted small bowel resection; 1 case of laparoscopic right right colon resection. The average laparoscopic operation time was (70.0 ± 28.6) min, average intraoperative blood loss was (13.5 ± 10.2) ml, average incision length was (3.4 ± 1.3) cm, mean postoperative exhaust time was (2.2 ± 0.8) Hospitalization (7.8 ± 2.9) d. Two patients (3.6%) had anastomotic bleeding and bandage obstruction. Follow-up 29 (5 ~ 50) months, no recurrence. Conclusions: Laparoscopy has a good effect in diagnosis and treatment of small intestinal hemorrhage. Laparoscopic small bowel surgery is a safe and effective minimally invasive surgical method, which is worthy of clinical application.