54例腹部切口疝病因分析

Cause analysis of 54 patients with incisional hernian of abdominal wall

目的探讨腹壁切口疝的发病原因。方法从切口类型、切口感染、腹内压增高、年龄、营养状况、发生时间等方面对54例切口疝进行回顾性分析。结果腹壁纵行切口、切口感染、腹内压增高及高龄、肥胖、代谢性疾病等因素的存在易诱发切口疝。54例切口疝患者中,6例小切口疝及5例中切口疝采用传统方法直接缝合修补,余病例均采用材料修补,随访0.5～3年,1例复发,经材料修补后痊愈。结论 1)围手术期应积极预防感染;(2)在不影响手术操作及安全的前提下,采用横向切口;(3)术后半年内注意防护,尽量避免一切诱发因素;(4)围手术期加强营养,控制血糖,治疗可引起腹内压增高的合并症。

Objective To explore the causes of incisional hernia of abdominal wall. Methods Ret- rospectively analyzed the clinical data of 54 patients with incisional hernia of abdominal wall from these aspects ： The type of incision, wound infection, intraabdominal pressure, age, nutritional status, time of occurrence. Results Longitudinal incision, wound infection, increased intraabdominal pressure and great age, obesity, metabolic diseases were high risk factors for the incisional hernia of abdominal wall. In 54 cases of incisional hernia patients, 11 cases were repaired by direct suture of the traditional method, others were repaired by artificial materials. The follow - up period ranged from 0.5 to 3 years, 1 case of recurrence was repaired by the materials and then recovered. Conclusions （ 1 ） Perioperative prevention of infection should be positive; （2）Without affecting the operation safe, the best choice of abdominal incision should be transverse incision ; （ 3 ） Pay attention to avoid all causative factor within six months after the operation ; （ 4 ） Perioperative nutrition should be strengthened. To control of the blood glucose actively. Treatment of those complications which can cause increased intraabdominal pressure.