摘要
目的对不同补片放置层次(肌后修补术与腹腔内修补术)治疗外科手术切口疝的疗效及并发症发生情况进行比较。方法回顾分析2015年1月至2018年1月,江苏省宜兴市人民医院普外科收治的切口疝72例患者的临床资料,其中采用腹腔内修补术35例(腹腔组),肌后修补术37例(肌后组),观察2组手术基本情况(手术时间、术后住院时间、住院总费用、术中出血量)、并发症(肠管损伤、肠梗阻、肠瘘、切口感染、切口脂肪液化);术后第1天、第3天疼痛视觉模拟评分(VAS)及随访1年的复发情况。结果腹腔组手术时间、术后住院时间均较肌后组短,而腹腔组术中出血量低于肌后组,但腹腔组住院总费用高于肌后组,差异有统计学意义(P<0.05);腹腔组肠管损伤、肠梗阻、切口感染及切口脂肪液化等发生率低于肌后组,腹腔组见1例(2.86%)肠瘘并发症,肌后组未有肠瘘并发症出现,2组组间差异无统计学意义(P>0.05);2组患者术后第1天、术后第3天VAS评分比较,差异无统计学意义(P>0.05);随访1年后腹腔组复发0例,肌后组在术后7个月时有2例(5.71%)复发,2组复发率无统计学意义(P>0.05)。结论两种术式不同补片放置层次方法治疗切口疝均有效,但腹腔内修补术治疗效果更佳,安全性高。
Objective To compare the efficacy and complications of different patch placement(sublay and intraperitoneal onlay mesh)in the treatment of incisional hernia.Methods A retrospective analysis on the clinical data of 72 patients with incisional hernia admitted to the Yixing People's Hospital from January 2015 to January 2018 was performed,including 35 cases of intraperitoneal onlay mesh(IPOM group)and 37 cases of retrorectus mesh placement(sublay group).The basic conditions of surgery(operation time,postoperative hospital stay,total hospitalization cost,intraoperative blood loss),complications(intestinal injury,intestinal obstruction,intestinal fistula,wound infection,incision fat liquefaction),Visual analogue scale(VAS)on the 1st and 3rd postoperative day and 1-year follow-up recurrence were observed.Results The operation time and postoperative hospital stay in the IPOM group were shorter than those in the sublay group,while the intraoperative blood loss in the IPOM group was lower than that in the sublay group;however,the total cost of hospitalization in the IPOM group was higher than that in the sublay group(P<0.05).The incidence of intestinal injury,intestinal obstruction,wound infection and incision fat liquefaction in the IPOM group were lower than those in the sublay group.In the IPOM group,1 case(2.86%)had intestinal fistula,and there was no intestinal fistula in the sublay group without significant difference(P>0.05).There was no significant difference in pain score between the two groups on the 1st day and the 3rd postoperative day(P>0.05).There was no recurrence in the IPOM group after 1 year of follow-up,and 2 cases(5.71%)recurrence in the sublay group after 7 months(P>0.05).Conclusion Both two patch placement methods are effective in treating incisional hernia,but intra-abdominal repair is better with less complications.
作者
高兴
史俊
吴思远
孙大千
洪岩
Gao Xing;Shi Jun;Wu Siyuan;Sun Daqian;Hong Yan(Department of General Surgery,the People's Hospital of Yixing City,Jiangsu,Yixing 214200,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2020年第2期171-174,共4页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
关键词
切口疝
肌后修补术
腹腔内修补术
疗效
并发症
Hernia
incisional
Sublay
Intraperitoneal Onlay Mesh
Efficacy
Complications
