腹股沟疝无张力修补术后迟发性补片感染16例诊治分析  

Analysis on diagnosis and treatment of 16 cases of late-onset mesh infection after tension-free hernia repair

作　　者：陈昕[1] 毛忠琦[1] 胡浩[1] 徐露[1] 殷骏[1] 胡优[1] 王钢[1] 周晓俊[1] Chen Xin;Mao Zhongqi;Hu Hao;Xu Lu;Yin Jun;Hu You;Wang Gang;Zhou Xiaojun(Department of General Surgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院普通外科,江苏省215006

出　　处：《中华疝和腹壁外科杂志（电子版）》2021年第2期146-149,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨腹股沟疝无张力修补术后迟发性补片感染的诊断及治疗方法。方法回顾性分析2012年8月至2017年8月,苏州大学附属第一医院收治的16例腹股沟疝无张力修补术后补片迟发性感染患者的临床资料。观察指标:(1)一般情况(2);手术情况;(3)术后情况;(4)随访情况。结果16例患者初次手术的方式包括:平片修补法(Lichtenstein),网塞填充修补法(Mesh Plug)及普理灵三合一无张力疝修补法(PHS)。补片感染时间平均为术后(7.3±2.4)个月;感染的细菌主要为金黄色葡萄球菌及大肠埃希菌;16例患者均行补片取出术,其中3例加行了腹腔镜探查术。手术时间为(66±31)min,术中出血量(32±11)ml,术后住院天数(20.4±5.4)d。术后无复发。结论腹股沟疝无张力修补术后迟发性补片感染少见,多需外科手术处理,补片取出术疗效确切,当怀疑补片突破腹膜时需加行腹腔镜探查术。Objective To evaluate the methods for the diagnosis and treatment of late-onset mesh infection after tension-free hernia repair.Methods Clinical data of 16 patients suffered from late-onset mesh infection after tension-free hernia repair at the first affiliated hospital of Soochow University from August 2012 to August 2017 was analyzed retrospectively.Observation indicators included(1)general condition,(2)operation situations,(3)postoperative situations,(4)follow up.Results The initial operation of 16 patients include:Lichtenstein hernioplasty,mesh plug hernioplasty and bilayer patch device for inguinal hernia(PHS).The mean time of mesh infection was(7.3±2.4)months.Staphylococcus aureus and escherichia coli were the main pathogens.All 16 patients were performed patch removal,and 3 of them received an additional laparoscopic exploration.The operative time was(66±31)minutes,the operative blood loss was(32±11)ml and the length of postoperative stay was(20.4±5.4)days.No recurrence occurred in 16 cases.Conclusion Delayed mesh infection after tension-free hernia repair is rare.It mainly depends on surgical management.The patch removal has obvious curative effect.An additional laparoscopic exploration is needed when the patch breaking through the peritoneum is suspected.

关 键 词：疝 腹股沟 疝修补术 补片感染 

分 类 号：R656.21[医药卫生—外科学]