摘要
目的总结采用腹腔内网片植入术（IPOM）法修补造口旁疝的方法和疗效.方法 采集2008年4月至2012年12月,山东大学附属山东省立医院收治的37例造口旁疝患者,从造口部位、造口大小、缝合技术、材料、切口感染、腹内压增高、年龄、体重、营养和发生时间等方面进行回顾性分析.结果 37例患者均顺利完成手术.手术时间115～178 min,平均（146.0±12.6） min.术后0.5～5 d拔除胃管,平均3 d;术后2～7 d拔除引流管,平均4 d.术后住院时间8～10 d,平均8.34 d.术后36例切口一期愈合;切口中段脂肪液化1例,切口感染1 例,均经换药后愈合.随访时间6～60个月,无皮下积液、肠坏死、肠梗阻等并发症,无复发,无死亡.结论 造口旁疝修补术后并发症重在预防,术前常规胃肠道清洁,网片恰当,缝合固定.术后通畅引流,积极预防感染,促进肠功能恢复等措施是降低术后并发症发生率的关键.
Objective To summarize the therapeutic method and effectiveness of parastomal hernia repair in situ with IPOM methods. Methods A total of 37 cases with parastomal hernia were retrospectively analyzed from April 2008 to December 2012 in terms of incision type and size, technique of suture, suture materials, infection of incision, increase of intraabdomial pressure, age, body weight, nutrition and the time of occurrence. Results IPOM technique repair was successfully performed in all patients. The operative time was 115 to 178 minutes with a mean of （ 146.0 ± 12.6） minutes. The gastric tube was pulled out 12 hours to 5 days （mean, 3 days） after operation. The drainage tube was taken out at the duration of 2 to 7 days （mean, 4 days ） after operation. The postoperative hospitalization time was 8 to 10 days （mean, 8.34 days）. And the incisions of 36 patients recovered with 1 wound healing. Incisional fat liquefaction was occurred in I case and infection was found in 1 case, and their incisions was healed after dressing was changed. The thirty-six patients were followed up 6 to 60 months, and no recurrence was observed. No occurrence of subcutaneous hydrops, intestinal necrosis, or intestinal obstruction. Conclusions The key to postoperative complications of parastoma hernia repair is prevention, including the gastrointestinal cleaning, appropriate mesh and intraoperative positive anchoring, unobstructed drainage, infection prevention, intestinal function, preventing seroma and incisional infection after operations.
出处
《中华疝和腹壁外科杂志（电子版）》
2013年第5期9-11,共3页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
基金
国家自然基金青年基金资助项目(81101858)
山东省自然基金面上资助项目(Y2007C102
ZR2011HM076)
山东省优秀中青年科学家基金资助项目(BS2010YY060)
山东省科技发展计划专项基金资助项目(2007H2071)
关键词
造口旁疝
疝修补术
Parastomal hernia
Herniorrhaphy
