摘要
目的总结采用人工材料无张力修补腹壁切口疝的临床经验和方法,探讨人工材料置于腹壁不同的层次对疗效的影响及围手术期处理。方法回顾性分析89例腹壁切口疝的手术方法、围手术期处理、术后并发症、引流的放置、抗生素的使用及随访结果。根据人工材料放置位置不同分为两组:前鞘前、腹膜或后鞘前,以是否一期愈合和复发作为评价指标进行两组间比较。结果患者平均年龄56.62岁;全部采用人工材料修补;人工材料分别放置于前鞘前(皮下)45例(50.56%)、腹膜前(肌层下)44例(49.44%);术后放置负压吸引69例(77.53%);全部使用抗生素预防感染;术后皮下积液8例(8.99%),切口延迟愈合7例(7.87%),肺部感染7例(7.87%);随访3.6年(0.5～5年),两组患者均无复发,两组间一期愈合率无显著差别。结论采用人工材料行无张力疝修补是合适的治疗腹壁切口疝的方法,人工材料置于腹壁不同层次均可取得良好疗效,良好的围手术期处理是疗效的重要保证。
Objective To summarize the clinical experience and method of repair of abdominal incisional hernia with tension-free procedures by using polypropylene mesh, and to discuss the effects of different position of the mesh on the outcome, and to analyse the perioperative treatment. Methods A retrospective study was conducted on 89 patients with abdominal incisional hernia. The surgical techniques, perioperative treatment, complications of operation, drainage, antibiotics, and the outcome were analysed. Based on the position of mesh, 89 patients were divided into two groups ： prefascia and preperitoneal group. The wound healing and recurrences of different groups were compared. Results The patient＇ s mean age was 56.62 years （ range 46-84 years）. All were treated with synthetic materials. The mesh were placed on subcutaneous （prefascia） in 57 patients, on retromuscolar（preperitoneal） in 32 patients. Drainage were used in 69 patients （77.53%）. Antibiotics were used in all patients. The postoperative complication include subcutaneous seroma in 8 cases（8.99% ）, delayed wound healing in 7 cases（7.87% ）, pulmonary infection in 7 cases （7.87%）. The average follow-up was 3.6 years （0.5-5 years）. There is no recurrence and no difference between two groups. Conclusions Tension free hernia repair by using synthetic materials is a reliable surgical techniques . The mesh can be placed on different layer of abdomen. Appropriate perioperative treatment is essential to outcome.
出处
《中华疝和腹壁外科杂志（电子版）》
2007年第2期84-86,共3页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
关键词
疝
人工材料
外科手术
Hernia
Surgical procedures, operative
Synthetic materials
