腹股沟疝修补术后急性感染去除补片指征的探讨  

Indication of mesh removal after acute infection following inguinal hernia repair

作　　者：张成鹏 郭新宇 郭晓[1] 李林强[1] 林汉[1] 陆朝阳[1] Zhang Chengpeng;Guo Xinyu;Guo Xiao;Li Linqiang;Lin Han;Lu Zhaoyang(Department of Liver and Abdominal Wall Hernia Surgery, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China)

机构地区：[1]哈尔滨医科大学附属第一医院肝脏与腹壁疝外科

出　　处：《中华疝和腹壁外科杂志（电子版）》2019年第5期413-416,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：吴阶平医学基金(320.6750.16206)

摘　　要：目的探讨腹股沟疝修补术后补片急性感染状态下补片去除的时机和指征。方法收集2016年1月至2018年10月,哈尔滨医科大学附属第一医院经治腹股沟疝修补术后补片急性感染患者12例,回顾性分析临床资料,并总结治疗经验。结果本组患者在术后1周至1个月确诊感染后经保守治疗3周至5个月取出感染补片,其中后期应用自制评分系统决定取出补片时机的患者4例。取出感染补片后切口愈合良好出院患者10例,2次手术取出残余补片患者1例,切口敞开患者术后持续真空负压吸引装置、术后3周突发心肌梗死死亡患者1例。随访患者11例,随访时间5个月至2.5年,随访期间手术侧腹股沟疝复发患者1例,但无感染迹象。其余患者切口恢复良好,无疝复发。结论腹股沟疝术后急性感染补片取出时机尚缺乏标准,本研究中自制评分系统是一个有益尝试。Objective To explore the timing and indication of mesh removal under acute infection after inguinal hernia repair. Methods From January 2016 to October 2018, twelve patients with acute infection after repair of inguinal hernia were treated in theFirst Affiliated Hospital of Harbin Medical University. The clinical results were retrospectively analyzed and the treatment experience was summarized. Results In this group, the patients were diagnosed of infection in 1 week to 1 month after the surgery, and the infected meshes wereremoved after conservative treatment for 3 weeks to 5 months after diagnosis. The latter 4 cases were treated withthe self-made scoring system to determine the timing of mesh removal. Of these, 10 patients discharged from hospital with good incision healing after removal of infected mesh, and one patient underwent reoperation to remove residual mesh. One patient with open incision sustained VSD after operation and died of myocardial infarction 3 weeks after operation. 11 patients were followed up for 5 months to 2.5 years. During the follow-up period, 1 case of inguinal hernia recurred, with no signs of infection. The other patients recovered well without hernia recurrence. Conclusion There is still a lack of standard for the timeofmesh removal of acute infection after inguinal hernia repair. The self-made scoring system in this study is a useful attempt.

关 键 词：疝 腹股沟 疝修补术 感染 

分 类 号：R656.21[医药卫生—外科学]