腹壁切口疝临床分析(附130例报告)

Analysis of Abdominal Incisional Hernia-Analysis of 130 cases

目的 探讨腹壁切口疝的病因和治疗。方法 回顾性分析 1 30例腹壁切口疝病人临床资料。结果 平均年龄 6 2 .8岁 ,女性占 5 8.5 %。术后一年内发病占 5 6 .2 % ,五年后发病占 2 6 .9%。纵型切口占 85 .4 % ,下腹部切口占 6 6 .9%。切口二期愈合者为 4 4 .6 %。 5 6例合成材料修补手术复发率为 7.1 %。结论 伤口二期愈合、腹内压升高、肥胖和糖尿病、老年人、女性、纵型切口、下腹部切口等是腹壁切口疝的致病因素 ;避免伤口感染 ,防治腹内压升高 ,促进伤口愈合 ,保证缝合质量是预防切口疝关键 ;大切口疝需使用合成材料修补 ,做好围手术期处理 。

Objective To explore the etiology and treatment of abdominal incisional hernia. Methods The clinical data of 130 cases of incisional hernia were analyzed retrospectively. Results The average age was 62.8% , 58.5% in female. The postoperative onset of incisional hernia was 56.2% within 1 year, 26.9% after 5 years. The hernia was 85.4% in longitudinal incision, 66.9% in lower abdominal incision. The incision secondary healing was 44.6% . 56 patients were repaired with synthetic material and their recurrent rate was 7.1% . Conclusion Incision secondary healing, obesity and diabetes, elevation of intraabdominal pressure, the aged, the female, longitudinal incision and lower abdominal incision are etiological factors of incisional hernia. To avoid infection of incision, prevent and cure increase of intraabdominal pressure, promote wound healing and ensure suture quality are the key of preventing incisional hernia. The patients with large incisional hernia must be repaired with synthetic mesh and subjected to perioperative management effectively to decrease the recurrence.