复发性腹壁切口疝患者个体化手术分析

Effect analysis of individualized surgery for patients with recurrent abdominal incisional hernia

目的分析复发性腹壁切口疝患者个体化手术治疗效果。方法 28例复发性腹壁切口疝患者根据实际情况选择个性化手术治疗,术后均进行观察和随访。结果本组28例患者均顺利完成腹部切口疝修补手术,平均手术时间(127. 36±46. 96) min,术后平均下床活动时间(1. 54±0. 56) d,平均肠排气时间(1. 8±0. 55) d,平均住院时间(9. 33±3. 15) d。3例发生补片上方积液,经2～3次穿刺抽吸加压后治愈; 1例出现不全性肠梗阻,经对症治疗好转;未见其他并发症发生。28例患者术后切口均I期愈合。所有患者均获随访,仅3例有轻微腹壁异物不适感,均无修补区域慢性疼痛,随访期内未见疝复发。结论根据复发性腹壁切口疝患者机体情况(年龄、体质量指数)、腹壁缺损大小等选择个性化手术修补治疗可显著改善患者预后。

Objective To analyze the effects of individualized surgery for patients with recurrent abdominal incisional hernia. Methods Totally 28 patients with recurrent abdominal incisional hernia were treated with individualized surgeries according to their actual conditions. All the patients were observed and followed up. Results All of the 28 patients successfully completed abdominal incisional hernia repair. The average operation time, average ambulation time after surgery, averageintestinal exhaust time and average hospital stay were （127.36±46.96） min, （1.54±0.56） d, （1.8±0.55） d and （9.33±3.15） d respectively. The fluid accumulated above the mesh was found in 3 cases, and was cured after 2 to 3 times of aspiration and compression. Incomplete intestinal obstruction was found in 1 case, and the condition was improved after symptomatic treatment. There were no other complications. All the incisions healed by stage I in 28 cases. All patients were followed up, and only 3 cases had slight discomfort caused by abdominal foreign body. There was no chronic pain in the repair area and no recurrence of hernia in follow-up period. Conclusion According to the physical condition （age,BMI） and the size of abdominal wall defects in patients with recurrent abdominal incisional hernia, different individualized surgical repair plans can significantly improve the prognosis of patients.