腹股沟疝无张力修补术后并发肠粘连的危险因素探讨及防治建议

Discussion on risk factors of intestinal adhesion after tension-free inguinal hernia repair and suggestions on prevention from and treatment of the illness

目的:探讨腹股沟疝无张力修补术后并发肠粘连的危险因素,并提出防治建议。方法:2015年1月-2018年6月收治腹股沟疝行无张力修补术的患者239例,根据术后是否发生肠粘连分为粘连组与未粘连组,分析影响术后并发肠粘连的危险因素。结果:随访术后患者239例,发生肠粘连20例,发生率为8.37%;粘连组年龄≥60岁、有腹部手术史、疝内容物为小肠或大网膜、补片类型为高分子材料补片及术后下床活动时间>24 h的比例均明显高于未粘连组,差异有统计学意义(P<0.05)。结论:老年、腹部手术史、疝内容物为小肠或大网膜、高分子材料补片及术后下床活动时间>24 h均是术后并发肠粘连的危险因素,临床工作中要积极采取针对性预防对策,以减少术后肠粘连的发生。

Objective:To investigate the risk factors of intestinal adhesion after tension-free inguinal hernia repair and to put forward some suggestions for prevention and treatment.Methods:From January 2015 to June 2018,239 cases of patients with inguinal hernia who underwent tension-free inguinal hernia repair were enrolled,according to whether intestinal adhesion occurred after operation,they were divided into adhesive group and non-adhesive group,while the risk factors affecting postoperative intestinal adhesion were analyzed.Results:239 cases of postoperative patients were followed up,a total of 20 patients had intestinal adhesion,with an incidence of 8.37%.The composition ratio of the adhesive group was significantly higher than that of the non-adhesive group,included≥60 years of age,history of abdominal surgery,hernia contents of small intestine or greater omentum,polymer mesh type and postoperative activity time of>24h,the differences were statistically significant(P<0.05).Conclusion:Old age,history of abdominal surgery,hernia contents of small intestine or greater omentum,polymer mesh and postoperative activity time of>24h are all risk factors for postoperative intestinal adhesion.Targeted preventive measures should be taken actively in clinical work to reduce postoperative intestinal adhesion.