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[1]李达周,江传燊,洪东贵,等.经脐入路内镜诊治腹部创伤的实验研究[J].医学研究与战创伤救治(原医学研究生学报),2019,21(4):343-347.[doi:10.3969/j.issn.1672-271X.2019.04.002]
　LI Da-zhou,JIANG Chuan-shen,HONG Dong-gui,et al.Study on diagnosis and treatment of abdominal trauma through embryonic natural orifice transumbilical endoscopic surgery[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2019,21(4):343-347.[doi:10.3969/j.issn.1672-271X.2019.04.002]
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经脐入路内镜诊治腹部创伤的实验研究()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第21卷
期数:
2019年4期
页码:
343-347
栏目:
基础研究
出版日期:
2019-07-20

文章信息/Info

Title:
Study on diagnosis and treatment of abdominal trauma through embryonic natural orifice transumbilical endoscopic surgery
文章编号:
1672-271X（2019）04-0343-05
作者:
李达周;  江传燊;  洪东贵;  何小建;  杨炳灿;  谢娇;  梁华东;  李胜兰;  王雯
作者单位：350025福州，解放军联勤保障部队第九○○医院消化内科（李达周、江传燊、洪东贵、何小建、王雯）；350025福州，福建医科大学福总临床医学院消化内科（杨炳灿、梁华东、李胜兰）；350025福州，厦门大学附属东方医院消化内科（谢娇）
Author(s):
LI Da-zhou1;  JIANG Chuan-shen1;  HONG Dong-gui1;  HE Xiao-jian1;  YANG Bing-can2;  XIE Jiao3;  LIANG Hua-dong2;  LI Sheng-lan2;  WANG Wen1
(1.Department of Gastroenterology,the 900th Hospital of the Joint Logistics Support Force，PLA，Fuzhou，Fujian，China; 2.Department of Gastroenterology，Clinical College of Fuzhou General Hospital，Fujian Medical University，Fuzhou 350025，Fujian，China; 3.Department of Gastroenterology，East Hospital Affiliated to Xiamen University，Fuzhou 350025，Fujian，China)
关键词:
经脐入路内镜手术;  腹腔探查;  腹部创伤;  软式内镜
Keywords:
embryonic natural orifice transumbilical endoscopic surgery;  abdominal exploration;  abdominal trauma;  soft endoscopy
分类号:
R459.7；R656
DOI:
10.3969/j.issn.1672-271X.2019.04.002
文献标志码:
A
摘要:
目的 通过动物实验研究经脐入路内镜手术（E-NOTES）诊治腹部创伤的可行性、有效性、安全性。 方法 12只成年雄性中华田园犬，体重（19.1±1.47）kg。使用软式内镜经脐制作腹部创伤动物模型，创伤类型包括小肠破裂、肝损伤、脾损伤各5处。4名实验人员分为造模2名和诊治2名，互相设盲。造模人员完成造模后，诊治人员使用软式内镜经脐进行内镜下腹腔创伤探查及治疗。记录内镜探查的效果及肝、脾及小肠损伤探查、治疗所使用的时间。观察术后2周生存率及一般生存情况。 结果 12只动物均顺利完成造模并行经脐入路内镜下探查。实验显示内镜在腹腔能够获得良好的视野和操作空间。15处创伤中有14处显示清晰，探查准确率93.3%，其中小肠破裂有1处漏诊。平均探查时间为（13.71±4.69）min。肝损伤、脾损伤模型均成功行内镜下治疗，1处小肠破裂因暴露不佳治疗失败，平均治疗时间为（8.49±4.30）min。术后2周12只犬均存活。饮水、饮食正常，活动度、精神状态佳，未见切口感染及相关并发症。 结论 E-NOTES作为诊治腹部创伤的初步方法，简便易行、安全、有效，为临床腹部创伤的诊治提供思路。
Abstract:
Objective To study the feasibility，effectiveness and safety of the diagnosis and treatment of abdominal trauma through embryonic natural orifice transumbilical endoscopic surgery (E-NOTES). Methods Twelve adult male Chinese rural dogs whose weight was （19.1±1.47）kg were selected.E-NOTES was adopted to make animal models with abdominal trauma，and trauma types include small intestine rupture，liver injury and spleen injury，five for each trauma.There were four experimenters，two experimenters were in charge of modeling and the other two experimenters were in charge of diagnosis and treatment， the two groups were blinded with each other.After modeling finished，two experimenters in charge of diagnosis and treatment conducted the abdominal trauma exploration and treatment by using a soft endoscopy.The effect of endoscopic examination and the time spent on probing and treating liver，spleen and small intestine rupture are recorded.After the operation，their survival rate and general survival situation were observed for two weeks. Results Twelve animals successfully completed the modeling and transumbilical endoscopic examination.Endoscope could got a good visual field and working space in the abdominal cavity.Among 15 abdominal trauma，14 were successfully identified (accuracy rate is 93.3% )，and one small intestine rupture was missed.The total average probe time was (13.71± 4.69) minutes.All liver damages and spleen injuries were successfully conducted with the endoscopic treatment，and a small intestine rupture was treatment failured due to poor exposure of the rupture.The total average treatment time was (8.49±4.30) minutes.All dogs survive two weeks after the operation，diet water quantity，mental state and activity basic close to normal.There was no incision infection and related complications. Conclusion E-NOTES is feasible，safe and effective as a preliminary diagnosing and treatment method of abdominal trauma.The clinical application of E-NOTES in the diagnosis and treatment of abdominal trauma deserves further study and promotion.

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备注/Memo

备注/Memo:
收稿日期：2019-03-09
更新日期/Last Update: 2019-07-11