腹疝治疗方法选择和手术材料选用的临床分析

Clinical analysis of the selections of treatment method and operative material for ventral hernia

目的探讨腹疝治疗方法的选择、手术材料的选用和相应的治疗效果。方法回顾性分析2011年9月至2018年10月的53例腹疝患者的临床资料,根据是否进行手术治疗将其分为保守组(8例)和手术组(45例),根据是否选用修补材料将手术组分为置入材料修补组及和折叠缝合组。分析各组的治疗情况。结果8例患者因不能耐受手术、手术获益小于创伤、经济受限、家庭因素等原因采用保守治疗。腹壁切口疝行折叠缝合法的患者为8例,略少于置入修补材料的11例。8例成人脐疝、15例白线疝患者选用折叠缝合法,多于置入修补材料的0、3例。折叠缝合组腹壁切口疝、白线疝患者的手术时间均短于置入材料修补组,差异具有统计学意义(P<0.05)。各组腹疝手术后随访期内无复发,但术后均可能出现切口积液、血清肿或疼痛等并发症。材料修补组的部分患者主诉切口下方有异物感。结论腹疝不能简单处置,应根据病例综合分析,采取个体化治疗并选择合适的方案,以减少复发,改善患者的生活质量。

Objective To explore the selections of treatment method and operative material for ventral hernia and the corresponding treatment effect. Methods The clinical data of 53 patients with ventral hernia from September 2011 to October 2018 were analyzed retrospectively. The patients were divided into conservative group(8 cases) and operation group(45 cases) according to whether the operation was performed or not. According to the choice of repair materials, the operation group was divided into implanted material repair group and folding suture group. The treatment situation of the each group was analyzed. Results Eight patients were treated conservative method due to no surgery intolerance, surgery benefit less than trauma, limited economy, family factors and other reasons. Eight patients were abdominal incisional hernia by folding suture, which were slightly less than 11 patients by the implanted material repair. Eight cases of adult umbilical hernia and 15 cases of white wire hernia were treated by folding suture, which were more than 0 and 3 cases by the implanted material repair. The operation time of patients with abdominal incisional hernia and white wire hernia in the folding suture group were shorter than those in the implanted material repair group, the differences were statistically significant(P<0.05). There was no recurrence in each group during the follow-up period, but postoperative complications such as incision effusion, seroma or pain may occur. Some patients in the implanted material repair group complained of foreign body sensation under the incision. Conclusion Ventral hernia can’t be treated simply. According to the comprehensive analysis of cases, individualized treatment should be adopted and appropriate scheme should be selected to reduce recurrence and improve the quality of life of patients.