腹壁整形术后小腹腔综合征三例

Three case reports of abdominal compartment syndrome after full abdominoplasty

目的探讨并总结腹壁整形手术后并发小腹腔综合征的防治方法，以提高腹壁整形手术的安全性。方法对2例腹壁整形术后并发小腹腔综合征患者行腹肌及其筋膜切开减压。所形成的腹壁缺损薄弱部分用人工网状材料（Mesh）修补。皮肤缺损用植皮术修补，1例症状轻微者，经指导增加腹式呼吸锻炼后缓解。结果2例经过上述方法治疗，症状消失和减轻，随访2年效果良好。结论腹壁整形手术可能并发小腹腔综合征。采用手术松解的方法可使症状缓解，并获得持久疗效。对高危人群，应采取适当的预防措施以提高手术的安全性。

Objective To improve the safety of the abdominoplasty by the study of the complication of abdominal compartment syndrome after abdominoplasty. Methods Three cases were analyzed and discussed respectively in aspects of clinic symptoms, pathological reason, treatments and follow-up results. The treatment was the incision of musculoaponeurotic system, which usually cause defect of abdominal wall after pressure releasing. The defect of musculoaponeurotic system was reconstructed by Mesh, and the defect of skin was repaired by skin graft. Results The pathologic change of the complications was the shrinking of the belly eavity＇s volume and the increasing internal pressure of the abdomen caused the internal pressure of the thoracic cavity increase. The clinical manifestations included compressive feelings of chest and abdomen, high urinary frequency and psychiatric symptom. 2 patients accepted the operation. The abdominal compartment syndrome disappeared after the operation, and the results of the two years follow-up were satisfied. Conclusions Full abdominoplasty has the risk of causing abdominal compartment syndrome. This complication can be cured by decompression of abdominal wall. The effect is stable after long time＇ s follow-up. Special preventive methods should be used in high-risk patients to avoid this complication.