在治疗左胸腹刺伤时,诊断性腹腔镜是必要的吗?
Hasan Okmen1, Kivilcim Ulusan1, Acar Aren2
1Department of General Surgery, Turkish Ministry of Health, Istanbul Training and Research Hospital, İstanbul-Türkiye.
概括
诊断性腹腔镜是有效的诊断腹膜破裂从胸腔腹腔刺伤,特别是当成像是不确定的或专家放射科医生是不可用的. 它有助于及时进行手术修复,改善患者的治疗结果.
科学领域:
- 创伤外科 手术 创伤外科
- 手术诊断手术诊断的使用方法
- 紧急医疗 紧急医疗
背景情况:
- 隔膜破裂的诊断是具有挑战性的,影响患者的结果.
- 刺伤引起的急性创伤性腹膜损伤带来了高发病率和死亡率.
- 器官带增加了腹膜损伤的严重程度.
研究的目的:
- 为了评估诊断腹腔镜对前胸腹部刺伤的疗效.
- 为了比较护膜损伤和没有护膜损伤的患者的随访结果.
- 为了评估成像与腹腔镜的诊断准确性.
主要方法:
- 刺伤患者的回顾性审查 (2012-2022年).
- 在腹腔镜检查后,根据腹膜损伤的存在将患者划分为组.
- 人口统计学分析,CT成像成功,相关伤害和手术结果.
主要成果:
- 对隔膜损伤的CT敏感度为63.16%;特异性为100%.
- 大多数变量在两组之间没有显著差异,除了腹膜损伤的较长操作时间 (P<0.01).
- 14名患者患有相关的内脏损伤.
结论:
- 诊断性腹腔镜是诊断腹膜破裂在紧急情况下的黄金标准.
- 当24小时放射科医生访问有限时,它特别有价值.
- laparoscopy 确保及时干预,当同一个团队密切监测患者是不可行的.
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