双切口法Ⅰ期无张力网片修补绞窄性腹股沟疝(附16例报告)  

The Application of Primary Repair via "Two Incisions" by Tension-free Mesh Patch for Incarcerated Inguinal Hernias(A Report of 16 Cases)

作　　者：吴国忠[1] 姜杰[1] 庞绍春[1] 

机构地区：[1]广东省农垦中心医院普外科,湛江524002

出　　处：《中国现代手术学杂志》2010年第1期22-23,共2页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨Ⅰ期无张力网片修补绞窄性腹股沟疝的可行性与安全性。方法16例腹股沟绞窄性疝患者,采用Ⅰ期无张力网片修补。首先于患侧采取中下腹探查切口进入腹腔,对有肠管坏死的14例进行切除及吻合,合并化脓性腹膜炎的6例患者,予腹腔冲洗及放置腹腔引流管,然后在内环口行荷包缝合结扎,关腹。重新消毒铺巾,更换器械,再取患侧内环口至外环口体表投影切口,按常规前入路进入腹股沟管,游离精索（不必分离疝囊）,于精索后用网片修补加固腹股沟管后壁。结果术后腹部切口感染1例,腹股沟切口无感染,16例随访12－90个月,未见复发。结论双切口法Ⅰ期无张力网片修补绞窄性腹股沟疝是一种安全有效的方法,可避免Ⅱ期手术,减轻患者痛苦,同时也可减轻患者的经济负担。Objective To explore the feasibility and safety of primary repair by using tension-free mesh patch in incarcerated inguinal hernias.Methods There were 16 cases of incarcerated inguinal hernia treated by the one step operation of enterectomy and the herniorrhaphy simultaneously.Firstly,the exploratory laparotomy was undergone using a mid lower abdominal incision for enterectomy and anastomosis.For the 6 cases complicated with suppurative peritonitis,peritoneal cavity irrigation and drainage was used.The first procedure was finished with the ligation of the internal ring by purse-string suture and then abdomen-closing.The second procedure began with new disinfection,new drape and new appliance.The inguinal hernia was repaired by the routine mesh plug tension-free herniorrhaphy. Results Abdominal incision infection was occurred in one case,and no inguinal incision infection was found.All the 16 patients were followed up,and no recurrence was found.Conclusion Primary repair via ＂two incisions＂ by using tension-free mesh patch is safe and effective for incarcerated inguinal hernias.

关 键 词：疝 腹股沟 疝修补术 

分 类 号：R656.21[医药卫生—外科学]