补片法治疗腹壁巨大切口疝的临床应用

Surgical treatment of abdominal giant incisional hernia with patch

目的 探讨腹壁巨大切口疝的病因、治疗及围手术期处理。方法 对我院 1998年 4月～ 2 0 0 3年 12月收治的 3 1例腹壁巨大切口疝临床资料进行回顾性分析。结果 所有患者采用复合补片 ( 19例 )或Marlex网片 ( 12例 )行巨大切口疝修补术。术后患者无严重并发症 ,均痊愈出院。随访 1～ 3年 ,无复发 ,疗效满意。结论 手术切口感染、腹内压增高和不规范手术操作是腹壁巨大切口疝的主要病因。围手术期处理对此病预后甚为关键 ,主要包括预防性应用抗生素和处理腹内压改变对机体产生的不良影响。应用人造补片修补腹壁巨大切口疝是一种安全、合理。

Objective To explore the etiology,treatment and the perioperative management of abdominal giant incisional hernia(AGIH).Methods Thirty-one patients with AGIH treated in our hospital from Apr.1998 to Dec.2003 were analyzed retrospectively.Results All the patients were treated by using the Composix patch (19 cases) or the Marlex patch(12 cases).The patients had no serious postoperative complications and were all cured.None of the patients recurred during a follow-up of 1～3 years and the effect was satisfied.Conclusion The infection of incision,increase of intra-abdominal pressure and the irregular operation are the main reasons of AGIH.The perioperative management is of great importance to the prognosis of AGIH and it mainly includes the use of prophylactic antibiotics and the management of adverse effects to the body because of the changes of intra-abdominal pressure.Repairing AGIH with artificial patch is a safe,rational and effective measure.