老年腹壁巨大切口疝修补方式的改进策略  

Improvement strategy of the repair mode on huge incisional fernia of abdominal wall in elderly patients

作　　者：周小平[1] 谢清[1] 何培生[1] 邹中辉[1] 李冠华[1] 

机构地区：[1]重庆三峡中心医院普外二科,重庆404000

出　　处：《湖南师范大学学报（医学版）》2015年第5期121-122,123,共3页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的 :集中探讨采用无张力平片修补术较常规加强缝合术在对老年患者腹壁巨大切口疝手术过程中的疗效对比。方法 :选取2013年6月~2014年4月因疝气于我院普外科进行手术治疗的老年患者104例,按照随机分配的原则,采用无张力平片加强内脏囊进行修复治疗的52例患者为观察组,另52例采用常规加强缝合治疗的为对照组,比较两组患者的临床效果。结果 :将两组患者治疗后疝囊内缺损发生率进行比较,对照组在术后疝囊内1个缺损发生率明显高于观察组患者,并且在疝囊手术中缺损发生的机率明显高于观察组患者,以上差异较大,具有明显的统计学意义;同时,观察组在治疗过程中较对照组术程更短、拔管时间更短、治疗更加经济有效;将两组患者治疗后术后并发率进行比较,同时将伤口感染率、血肿和腹壁僵硬发生率纳入对比观察。除伤口浅部感染发生率的比较中,两组差异不大,其他各项的比较中,观察组均优势明显,具有统计学意义。结论 :因采用无张力平片加强内脏囊进行修复的过程中更加安全、术后并发症少同时伴有耗时短的优势,值得在临床中推广使用。Objective To investigate the effects of tension-free hernioplasty and general strengthen suture in operation. Methods Collected 104 elderly patients with operation in our general surgery department from 2013 June to 2014 April, divided into observation group received tension-free hernioplasty strengthening the visceral sac amd control group received general strengthen suture with 52 cases per subgroup randomly. To compare the clinical effects of two groups. Results The deletion occurrence of hernial sac in control group was higher than that of observation group during and after operation. The operation time, TTE and treatment cost of observation group were better than those of control group. There was not difference of superficial infection in two groups, the hematoma occurrence and abdominal wall stiffness occurrence of observation group were better than those of control group. Conclusion Tension-free hernioplasty strengthening the visceral sac on huge incisional fernia of abdominal wall in elderly patients can improve security, reduce complication and operation time and be worthy of application.

关 键 词：老年 腹壁巨大切口疝修补 无张力平片修补 加强缝合腹壁 

分 类 号：R656.2[医药卫生—外科学]