腹股沟嵌顿疝153例一期修补临床经验

Mesh repair for patients with incarcerated groin hernias: A retrospective study of 153 cases

目的探讨腹股沟嵌顿疝的术式选择,放置补片的指征,术后并发症的影响因素及处理方法。方法回顾性分析2005年8月至2014年7月,杭州市第一人民医院153例接受手术治疗腹股沟嵌顿疝患者的临床资料,统计分析一般情况、疝类型、发病至就诊时间、手术方式、是否放置补片及补片类型、术后并发症。结果本组患者,71例行肠切除,82例行无肠切除。肠切除主要风险因素为性别、年龄、疝类型、痴呆等精神疾病、嵌顿时间等。本组患者放置补片76例,补片感染者2例,1例移除补片,无复发。结论肠切除不是补片修补的禁忌,对于相对清洁的创面可选择补片修补,对患者减少复发的获益大于增加的潜在感染风险。

Objective To research the treatment of incarcerated groin hernia and the opportunity for mesh repair,to investigate the influencing factors and management of postoperative complications. Methods This study was conducted on 153 patients with incarcerated inguinal hernias who presented to Hangzhou First People＇s Hospital and accepted an emergency surgery during August 2005 to July 2014. All patients＇ general condition,hernia type, hospitalization time, surgical procedures, mesh type and complications were collected,reviewed and analyzed. Results 71 patients underwent bowel resection in the total of153 patients. The main risk factors for bowel resection were gender,age,hernia type,dementia,and delay hospitalization. 76 patients＇ hernia were repaired with mesh. 2 of them had mesh infection,one should be removed,and none recurrence developed. Conclusion Bowel resection is not the contraindication of mesh repair. It may have more benefits in term of recurrence rather than increasing the risks of infection in cleancontamination field.