无张力疝修补术后补片感染的手术治疗  

Reoperation of mesh infection after tension-free herniorrhaphy

作　　者：王鑫[1] 杨福全[1] 王泽平[1] 马锐[1] 丛玉珠 孟令勤[1] 赵海鹰[1] 刘金钢[1] 

机构地区：[1]中国医科大学附属盛京医院胆道、疝、减肥外科,沈阳110004

出　　处：《中华普通外科杂志》2014年第6期437-439,共3页Chinese Journal of General Surgery

基　　金：辽宁省自然科学基金资助项目（20102297）

摘　　要：目的 探讨腹股沟疝无张力修补术后补片感染的预防和再手术时机及方法.方法 回顾性分析2003年1月至2012年12月中国医科大学附属盛京医院收治的18例腹股沟疝无张力修补术后补片感染患者的资料.其中Lichtenstein无张力修补13例,疝环填充式无张力修补5例.应用聚丙烯补片修补者16例,膨体聚四氟乙烯补片修补者2例.根据感染程度、补片材料进行相应处理.开放换药未见好转后行再手术治疗.术后均一期缝合,完全去除补片者3例,术后留置引流管;部分去除补片者15例,予以双套管冲洗负压吸引.结果 补片感染的18例患者均经再手术治愈出院.无围手术期死亡,手术后无疼痛、阴囊水肿及尿潴留.其中16例一期愈合,2例二期愈合.随访6个月至3年,18例患者切口愈合良好,出院后无感染及复发.结论 腹股沟疝无张力修补术后补片感染的治疗以预防为主,根据感染类型及补片材料选取不同的治疗方式.Objective To investigate the prevention and the timing of reoperation and treatment of mesh infection after tension-free herniorrhaphy for inguinal hernia.Methods There were 18 mesh infections admitted from Jan.2003 to Dec.2012.Originally 13 cases were treated by Lichtentein repair,5 cases by mesh plug.Flat knitted polypropylene was used in 16 cases,polytef in 2 cases.Meshes were completely removed in 3 cases,partially removed in 15 cases.Tube drainage and suction were used and incision was sutured one stage.Results All the patients were reoperated and cured,with no perioperative death,no pain,no scrotal edema and urinary retention.16 cases were healed by first intention,the other 2 cases with delayed healing.Patients were followed up from 6 months to 3 （1.8 ± 0.4） years,with no recurrence of hernia and wound infection.Conclusions Treatment of mesh infection after tension-free herniorrhaphy for inguinal hernia relies mainly on prevention.Reoperation and mesh removal offers a chance of healing for cases intractable to conservative therapy.

关 键 词：疝 腹股沟 再手术 切口感染 疝修补术 

分 类 号：R656.2[医药卫生—外科学]