合成网片在污染腹壁疝手术中的应用  

Clinical application of synthetic mesh in contaminated ventral hernia

作　　者：郭晓波[1] 石玉龙[1] 

机构地区：[1]山东大学附属省立医院胃肠外科,济南250021

出　　处：《中华普外科手术学杂志（电子版）》2014年第3期21-23,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：山东省自然基金面上项目(Y2007C102);山东省科技攻关计划(2007H2071);国家自然基金青年基金项目(81101858)

摘　　要：目的探讨人工合成网片在污染腹壁疝手术中应用的安全性及可行性。方法回顾性分析了2006年1月至2013年4月收治的术中有污染的切口疝、造口旁疝患者17例,分析其手术中的污染情况,所用Proceed合成网片的特点、术中处理和术后并发症的发生情况。结果 17例患者术中出现肠破裂、肠切除等而造成污染,经处理后我们应用人工合成网片全部完成Ⅰ期修补。术后1、3、6、12个月门诊随诊,随访时间最长达60个月以上。17例患者未发现复发,术后并发症发生率17.6%(3/17),1例患者出现切口感染;1例患者2年半后发生网片感染,经清创换药后痊愈;1例患者发生肠梗阻,经非手术治疗后恢复。结论在污染腹壁疝手术中只要术中恰当处理污染、选择合适的合成网片,是可以应用人工合成网片完成Ⅰ期修补。Objective To investigate the safety and feasibility of synthetic mesh in contaminated ventral hernia operation .Methods The clinical data were retrospectively analyzed in 17 patients with contaminated incisional hernia and parastomal hernia who had undergone surgery between January 2006 and April 2013.We analyzed the contamination of previous surgery , application features of synthetic mesh , intraoperative management and the occurrence of postoperative complications .Results Outpatient follow-up was performed at 1, 3, 6 and 12 months after operation .All the 17 patients showed no recurrence . Postoperative complication rate was 17.6%（3/17）.There were 1 case of wound infection, 1 case of mesh infection 2 years and 6 months after operation , which was healed after debridement and dressing , and 1 case of bowel obstruction , which was recovered after conservative treatment .Conclusion The operation for contaminated ventral hernia should emphasize the management of pollution , use of appropriate synthetic mesh, which could be applied to stageⅠrepairment.

关 键 词：疝 腹部 合成网片 消毒 

分 类 号：R656.2[医药卫生—外科学]