摘要
目的:探讨腹壁巨大切口疝的修补方法及围手术期处理。方法:回顾性分析2005～2008年期间收治的6例腹壁巨大切口疝患者的临床资料:男5例,女1例,年龄52～71岁,平均63岁。发病5～22月,平均12月。疝环缺损直径12～20cm,平均15cm。合并双下肢深静脉血栓形成并高血压、高心病、多囊肾及肾功能不全1例,慢支炎、肺气肿并腹股沟巨大复发疝1例,高血压并糖尿病1例,前列腺增生症1例,低蛋白血症1例。6例均行开放手术用复合补片Composix行腹腔内修补(Underlay),1例合并腹股沟巨大复发疝者加用超普(Ultrapro)网片行腹股沟区腹膜前修补。结果:全部病例均安全度过手术期,经随访8个月～3.5年,无1例出现复发、肠梗阻等并发症。结论:围手术期处理甚为关键,主要包括控制基础疾病、预防性使用抗生素和防止腹内压改变对机体产生的不良影响。复合补片腹腔内修补腹壁巨大切口疝是一种安全、有效的治疗方法。
Objective：To investigate intraperitoneal repair and perioperative management of huge incisional hernia on abdominal wall.Methods：A retrospective study was done to analyze the clinical data of 6 patients who had undergone intraperitoneal repair for huge incisional hernia on abdominal wall from 2005 to 2008.Five males and 1 female,with an average age of 63 years（range,52 to 71 years）,and duration of illness ranged from 5 to 22 months（average,12 months） were included.The diameters of defective hernial sac varied from 12 to 20 cm,averaging 15 cm.One case was complicated with hypertension,hypertensive cardiopathy,polycystic kidney and organic renal insufficiency and deep vein thrombosis（DVT） at lower limbs;one with chronic bronchitis,emphysema and huge inguinal recurrent hernia;one with hypertension and diabetes;one with hyperplasia of prostate and one with hypoproteinemia.Open Underlay surgery was performed to repair the 6 cases with Composix.The patient complicated with huge inguinal recurrent hernia received additional repair with Ultrapro mesh in the preperitoneal inguinal region.Results：All cases went through the operation period uneventfully.Follow-ups from 8 months to 3.5 year revealed no such complications as recurrence and intestinal obstruction.Conclusion：The crucial perioperative managements mainly include control of the basic complicated diseases,preventive use of antibiotics and prevention of adverse effects caused by changes in intra-abdominal pressure（IAP）.Underlay with Composix is a safe and effective method of repairing the huge incisional hernia on abdominal wall.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2010年第3期474-476,共3页
Journal of Chongqing Medical University
关键词
腹壁巨大切口疝
复合补片
腹腔内修补
Huge incisional hernia on abdominal wall
Composix
Underlay
