【摘要】：目的:通過探討兩種手術方式治療復發性腹壁切口疝的臨床效果,證實腹腔鏡修補復發性腹壁切口疝的安全性及可行性。方法:回顧性總結2006年06月至2016年12月收治的102例復發性腹壁切口疝患者的臨床資料,其中Onlay修補法(肌鞘前的修補)56例,腹腔鏡修補法46例,比較分析兩組手術時間、術后下地時間、術后住院時間、術后疼痛、術后并發癥、住院費用及復發率。結果:腹腔鏡修補組的手術時間、住院費用高于Onlay修補組,差異有統計學意義(P0.05);Onlay修補組術后血清腫7例,切口感染5例,腸管損傷4例,術后疼痛4例,不全性腸梗阻各3例,并發癥共計23例(41.07%)。腹腔鏡修補組術后血清腫2例,切口感染2例,腸管損傷5例,術后疼痛1例,不全性腸梗阻2例,并發癥共計12例(19.57%)。兩組患者并發癥經對癥治療后均好轉,未發生補片感染,慢性疼痛,腸瘺等。兩組比較,腹腔鏡修補組并發癥的發生率低于Onlay修補組(P0.05),術后住院時間、下床活動時間短于Onlay修補組,差異有統計學意義(P0.05)。結論:腹腔鏡修補術治療復發性腹壁切口疝具有術后下地時間早、術后住院時間短、術后并發癥少等優點,但住院費用高、手術時間長,兩者術后復發率相近。兩種手術方式治療復發性腹壁切口疝均為安全、有效的。兩者手術方式如何選擇應根據患者實際情況及外科醫生的技術、經驗決定。
[Abstract]:Objective: to investigate the safety and feasibility of laparoscopic repair of recurrent abdominal incisional hernia. Methods: the clinical data of 102 patients with recurrent abdominal wall incisional hernia from June 2006 to December 2016 were retrospectively reviewed, including 56 cases with Onlay repair (anterior muscle sheath repair) and 46 cases with laparoscopic repair. The operative time of the two groups was compared and analyzed. Postoperative floor time, postoperative hospitalization time, postoperative pain, postoperative complications, hospital expenses and recurrence rate. Results: the operative time and hospitalization cost of laparoscopic repair group were significantly higher than that of Onlay repair group. The difference was statistically significant (P0.05). There were 7 cases of postoperative serum swelling, 5 cases of incision infection, 4 cases of intestinal injury, 4 cases of postoperative pain and 3 cases of incomplete intestinal obstruction in the laparoscopic repair group. A total of 23 cases (41.07%) had complications. In the laparoscopic repair group, there were 2 cases of serum swelling, 2 cases of incisional infection, 5 cases of intestinal injury, 1 case of postoperative pain, 2 cases of incomplete intestinal obstruction, and 12 cases (19.57%) of complications. The complications of the two groups were improved after symptomatic treatment, no patch infection, chronic pain, intestinal fistula and so on. The incidence of complications in the laparoscopic repair group was lower than that in the Onlay repair group (P0.05). The postoperative hospitalization time and the time to get out of bed were shorter than those in the Onlay repair group (P0.05). Conclusion: laparoscopic repair for recurrent abdominal incisional hernia has the advantages of early operation time, short hospitalization time and less postoperative complications, but the cost of hospitalization is high, the operation time is long, and the recurrence rate of both is similar. Both surgical methods are safe and effective in the treatment of recurrent abdominal incisional hernia. The choice of the two surgical methods should be based on the actual situation of the patient and the surgeon's skill and experience.
【學位授予單位】：新疆醫科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R656.2

【相似文獻】

相關期刊論文 前10條

1 陳金國,魯潤鵬,王震;腹壁切口疝26例治療體會[J];河北醫藥;2002年02期

2 李廣永 ,周旭宇 ,李剛;腹壁切口疝80例原因分析及預防[J];人民軍醫;2003年04期

3 唐健雄,陳革,黃磊;開放式完全腹腔內修補治療腹壁切口疝的方法及經驗介紹[J];外科理論與實踐;2004年04期

4 鄭民華,毛志海;腹壁切口疝的腹腔鏡修補術[J];臨床外科雜志;2005年02期

5 熊先澤;程南生;彭其芳;易江;;巨大腹壁切口疝治療體會(附11例臨床分析)[J];華西醫學;2006年02期

6 王新波;朱維銘;;腹壁切口疝的治療進展[J];中國實用外科雜志;2006年11期

7 陳緒安;;腹壁切口疝20例手術治療體會[J];山東醫藥;2007年21期

8 周建平;任峰;;腹壁切口疝的外科治療[J];中國現代手術學雜志;2007年05期

9 劉強;包海燕;楊斌;;腹壁切口疝病因分析(附34例病例報告)[J];新疆醫學;2008年12期

10 徐大華;劉家峰;劉東斌;劉強;王劍;;腹腔鏡修補多發性腹壁切口疝[J];中國實用外科雜志;2008年12期

相關會議論文 前7條

1 高國棟;王平;楊，

本文編號：2250365