开放腹壁疝网片修补术早期并发症的影响因素分析  

Factors open abdominal hernia mesh repair analysis of early complications

作　　者：金曜[1] 徐继宗[2] 杨帆[1] 张弦 Jin Yao;Xu JIzhong;Yang Fan;Zhang Xian(Department of General Surgery,Huazhong University of Science and Technology Hospital,Wuhan 430080,China;Deportment of General Surgery,Second People's Hospital of Yichang(Second People's Hospital,Three Gorges University),Yichang 443000,China;Deportment of General Surgery,China Resourse WISCO Hospital,Wuhan 430080,China)

机构地区：[1]华中科技大学医院普外科,武汉430000 [2]宜昌第二人民医院普外科(三峡大学第二人民医院),湖北443000 [3]华润武钢总医院普外科,武汉430000

出　　处：《中华疝和腹壁外科杂志（电子版）》2021年第4期398-400,共3页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨分析开放腹壁疝网片修补术早期并发症的影响因素。方法回顾性2008年2月至2019年6月,华中科技大学医院932例成人开放腹壁疝网片修补术患者的临床资料,其中腹股沟疝856例,脐疝76例,比较不同的防治措施对早期并发症的影响,分析其临床价值。结果932例患者中出现早期并发症共44例,其中切口感染4例,血清肿39例、慢性疼痛6例。是否预防性使用抗生素不会影响切口感染率(P>0.05),腹带加压较传统的盐袋加压可减少术后血清肿的发生(P<0.05),显示术中常规探查髂腹下神经和髂腹股沟神经与不做神经探查比较差异无统计学意义(P>0.05)。结论腹股沟疝术前无需预防性使用抗生素。腹壁疝术后伤口腹带加压较传统盐袋效果更佳,结合负压吸引可加速患者康复,降低术后并发症。术中探查神经虽然可以避免神经损伤及误缝扎、压迫,但神经的损伤并不是导致患者术后慢性疼痛的唯一因素,无需为了避免慢性疼痛而刻意常规探查神经。Objective To retrospectively analyze the influencing factors of early complications of open abdominal hernia mesh repair,compare the advantages and disadvantages of different prevention and treatment measures,and explore its clinical application value.Methods A retrospective analysis of our hospital from February 2008 to June 2019 is open to adults abdominal hernia mesh repair in patients with clinical data of a total of 932 cases,of which 856 cases of inguinal hernia,incisional hernia 138 cases,compare different prevention impact of the measures on early complications,their clinical value.Results A total of 44 of the 932 patients developed early complications,including 4 cases of incision infection,39 cases of seroma,and 6 cases of chronic pain.Whether or not prophylactic antibiotics were used did not affect the incisional infection rate(P>0.05),compared with the traditional salt bag compression,abdominal compression could reduce the occurrence of postoperative seroma(P<0.05),and there was no significant difference between routine intraoperative exploration of the ilioabdominal inferior nerve and ilioinguinal nerve and that without nerve exploration(P>0.05).Conclusion Prophylactic antibiotics are not required for inguinal hernia.Compared with traditional salt bags,abdominal compression of the wound after abdominal hernia surgery is more effective.Combined with negative pressure suction,it can accelerate the recovery of patients and reduce postoperative complications.Although intraoperative nerve exploration can avoid nerve injury,missutures and compression,nerve injury is not the only factor leading to chronic pain after surgery,and there is no need to deliberately routine nerve exploration in order to avoid chronic pain.

关 键 词：腹壁疝 切口并发症 影响因素 防治措施 

分 类 号：R656.2[医药卫生—外科学]