摘要
目的探讨腹腔镜下腹腔内补片置入术治疗腹壁巨大切口疝的临床疗效,为腹壁巨大切口疝的治疗提供理论依据。方法回顾性分析新疆维吾尔自治区人民医院2014年1月至2015年1月期间收住的32例行手术治疗的腹壁巨大切口疝患者的临床资料,对患者术前进行心理疏导、呼吸功能锻炼、腹腔扩容准备;术后密切观察生命体征变化情况,防止腹内压急剧增加及预防并发症的发生,同时对患者做好出院指导。结果所有患者均经腹腔镜顺利完成手术,手术时间85~138 min,平均手术时间109 min,术后住院时间4~9 d,平均住院时间6 d。术后出现浆液肿1例,给予穿刺抽液及腹带包扎加压处理后治愈;腹胀1例,2 d后缓解;切口感染1例,给予积极换药处理后治愈,无肠管损伤、呼吸循环衰竭等严重并发症的发生。随访时间3~26个月,平均随访时间12个月,均未出现切口疝复发。结论对行腹腔镜下腹腔内补片置入术治疗腹壁巨大切口疝的患者围手术期给予精心准备与指导,可促进患者快速康复,降低相关并发症的发生及切口疝的复发,是取得良好手术疗效的重要保障。
Objective To discuss the clinical effect of laparoscopic intraperitoneal onlay mesh in the treatment of giant abdominal incisional hernia. Method A retrospective analysis was conducted on 32 cases of giant abdominal incisional hernia admitted to the People＇ s Hospital of Xinjiang Uygur Autonomous Region from January 2014 to January 2015. Psychological counseling, respiratory function exercise and abdominal expansion preparation were given to patients before operations; postoperative vital signs were closely observed, to prevent the occurrence of a sharp increasing of intra- abdominal pressure and complications. At the same time, detailed discharge guidance was given to these patients. Results All patients were successfully completed the operation by laparoscopy, and the operation time was 85 to 138 minutes. The average operation time was 109 minutes, and the postoperative hospitalization time was 4 to 9 days （average of 6 days）. Postoperative seroma occurred in 1 cases, treated with puncture and abdominal compression bandaging treatment ; 1 cases of abdominal distension, relieved in 2 days ; 1 cases of wound infection cured by dressing change treatment; no serious complications occurred, such as intestinal injury, respiratory and circulatory failure. All patients were followed up for 3 to 26 months with an average of 12 months, there was no recurrence of incisional hernia. Conclusion The perioperative preparation and guidance of laparoscopic intraperitoneal onlay mesh in the treatment of giant abdominal incisional hernia patients, can promote the rehabilitation of patients, and reduce the occurrence of incisional hernia complications and recurrence, is an important guarantee for good operation effect.
出处
《中华疝和腹壁外科杂志（电子版）》
2017年第3期174-176,共3页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
基金
新疆维吾尔自治区成果转化项目(201554144)
关键词
疝
腹腔镜
护理体会
Hernia
Laparoscopes
Nursing experience
