探讨在外科急诊诊疗过程中腹腔镜技术在急诊直肠损伤中应用的可行性及安全性。

回顾分析2015年1月至2018年1月期间急诊行腹腔镜探查及治疗的30例直肠损伤患者的病例资料。

30例直肠损伤患者包括，刀刺或异物刺伤13例，车祸伤10例，医源性损伤7例。所有患者均行腹腔镜探查，其中位于腹膜反折线以上18例，行单纯破损修补5例、破损修补＋乙状结肠造瘘9例、破损切除吻合4例；位于腹膜反折线以下12例，均行乙状结肠造瘘，无中转开腹。手术时间45～200 min，平均75 min；术中出血10～100 ml，平均32 ml；术后住院时间3～13 d，平均5.6 d。术后3～6月行造瘘还纳，痊愈。

腹腔镜技术在急诊直肠损伤中具有可行性及安全性，且简便实用、具有创伤小、术后恢复快等优点，具有推广价值。

To investigate the feasibility and safety of laparoscopy in the diagnosis and treatment of acute rectal injuries.

The clinical data of 30 patients with acute rectal injuries treated in our department from January 2015 to January 2018 were retrospectively analyzed.

Among the 30 cases of rectal injuries, there were 13 cases of knife stabbing or foreign body stabbing, 10 cases of traffic accident injury and 7 cases of iatrogenic injury. All the patients underwent laparoscopic exploration, among them there were 18 cases of rectal injury above peritoneal reflex line. There were 5 cases of simple injury repair, 9 cases of injury repair combined with sigmoidostomy, 4 cases of rectal anterior resection. 12 cases of injury below peritoneal reflex line received sigmoidostomy without conversion. The operation time ranged from 45 to 200 minutes, with an average of 75 minutes. The intraoperative bleeding ranged from 10 to 100 ml with an average of 32 ml. The postoperative hospital stay ranged from3 to 13 days, with an average of 5.6 days.3 to 6 months after surgery, patients received closure of stoma.

Laparoscopic technique is feasible and safe in emergent rectal injury, and it is simple and practical, with such advantages as minimalinvasion and fast postoperative recovery, whichis worth of clinical promotion.