3种不同层次间放置补片治疗腹壁疝的临床疗效  

Curative effect analysis of three mesh positions for treatment of ventral hernia

作　　者：陈亚柯[1] 陈建民[1] 王殿琛[1] 张轶 屈攀 唐健雄[2] CHEN Yake;CHEN Jianmin;WANG Dianchen;ZHANG Yi;QU Pan;TANG Jianxiong(Department of Hernia and Abdominal Wall Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,R.P.China;Department of General Surgery,Donghua Hospital Affiliated to Fudan University,Shanghai 200040,R.P.China)

机构地区：[1]郑州大学第一附属医院疝和腹壁外科,郑州450052 [2]复旦大学附属东华医院普外科,上海200040

出　　处：《中国普外基础与临床杂志》2021年第1期38-42,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：河南省2017年科技发展计划(项目编号:172102310274)。

摘　　要：目的探讨3种不同层次间放置补片治疗腹壁疝的临床疗效。方法收集2015年1月至2017年1月期间在郑州大学第一附属医院行腹壁疝修补术治疗的87例患者的临床资料。其中腹壁肌肉前放置补片(Onlay)28例,腹壁肌肉间放置补片(Inlay)27例,腹壁肌后放置补片(Sublay)32例。比较分析3种不同术式的疗效及并发症。结果所有患者均康复出院;术后出现切口血肿2例,脂肪液化6例,浅表感染1例,经外科换药处理后均顺利出院;随访时间3~36个月、平均随访时间8个月,有3例复发。结论3种不同术式都能有效治疗腹壁疝,Sublay手术疼痛轻,并发症少,治疗效果更具有优势;但腹壁疝病情复杂,临床应加强术前病例的筛选,选择合适的手术方式并加强术后管理以预防和减少疝复发。Objective To study the clinical efficacy of three mesh positions for treatment of ventral hernia.Methods The data of 87 patients undergoing abdominal incision hernia repair from January 2015 to January 2017 in the First Affiliated Hospital of Zhengzhou University were analyzed respectively.They were divided into three groups according to the different mesh position,Onlay treatment(n=28),Inlay treatment(n=27)and Sublay treatment(n=32).The curative effect and complications of three different surgical methods were compared and analyzed.Results All the patients were recovered and discharged.A total of 6 cases among 87 patients had incision fat liquefaction,1 patient had superficial infection and 2 patients had postoperative incision hematoma.After 3 to 36 months of follow-up(average 8 months),3 cases of 87 patients recurred.Conclusions Three kinds of surgeries for ventral hernia are feasibility and value,Sublay treatment is not only less pain and complications but more effective.We should strengthen the screening of preoperative cases and selecting appropriate surgical methods to prevent and reduce the recurrence of hernia.

关 键 词：腹壁疝 疼痛 疝修补 疝复发 

分 类 号：R656.2[医药卫生—外科学]