腹部切口疝81例临床分析

Clinical Analysis of Patients with Incisional Hernia (A Report of 81 Cases)

目的：总结治疗腹部切口部的经验和体会。方法：对1979年12月至1998年3月间收治的81例腹部切口疝患者进行随访、分析。结果：引起切口疝的原因依次为切口感染34例，呼吸系统疾患11例，结肠造瘘四间隙过大2例。腹壁缺损＜5cm的40例，5～15cm的36例，＞15cm的5例。结论：腹部手术后切口感染及并发的呼吸道疾患是引起切口疝的重要原因，而修补术后的复发除了上述原因以外手术操作不当也是一个重要原因。对于巨大切口疝应进行充分的术前准备方可手术，单纯修补同样可取得满意的疗效。术后防止切口感染及呼吸道疾患的发生可降低切口迹的复发率。

Objectives: To summarize the experiences about clinical treatment of incisional hernia. Materials and Methods:Follow- up and analysis were made in 81 patients with incisional hernia between December 1977 and March 1998. Results:The causative factors of incisional hernia were the wound infection, disease of respiratory system, and the larger colostomy in34, 11, and 2 patients respectively. Conclusions: The important causes in the development of incisional hernia are postopera-tive wound infection and respiratory disease. Inappropriate handling of repair may play an important role in the recurrence ofhernia in addtion to the conditions mentioned above. Preoperative preparations are necessary in the patients with giant incision-al hernia. Repair by resuturing is safe and effective in these patients. Recurrence rates may be reduced by preventing postoper-ative wound infection and respiratory diseases.