摘要
目的探讨封闭持续负压血浆管在预防腹股沟斜疝(疝囊坠入阴囊)术后并发症的应用价值。方法回顾性分析笔者所在医院2011年4月至2016年6月期间收治的成年男性腹股沟巨大斜疝107例(嵌顿疝16例,非嵌顿疝91例)患者的临床资料,均采用超普疝装置(UHS)腹股沟疝腹膜前间隙无张力修补术,除嵌顿疝、糖尿病、老年患者外所有患者均未预防性使用抗生素。其中61例患者留置脑外科多侧孔血浆引流管,经阴囊皮肤另戳孔引出固定,46例未留置血浆管。观察2组患者术后阴囊胀痛、阴囊血肿、阴囊积液及切口感染发生情况。结果 61例留置血浆管患者中,平均置管时间2 d,最长置管时间5 d;出现术后阴囊胀痛2例(3.3%),无阴囊血肿及阴囊积液发生;有1例血浆管引流不通畅,经空针抽吸5 d后拔管,痊愈出院;平均住院时间4 d。46例未留置血浆管患者中,出现阴囊胀痛7例(15.2%)、阴囊血肿7例(15.2%),无阴囊积液及切口感染发生,平均住院时间6 d。未留置引流管组阴囊胀痛和阴囊血肿发生率明显高于留置引流管组(P<0.05)。6例阴囊血肿予门诊换药、反复抽吸血肿1~3次后好转,1例反复抽吸无效、行阴囊切开置管引流、换药后好转。结论封闭持续负压血浆管可预防腹股沟巨大斜疝术后阴囊胀痛及阴囊血肿的发生,对切口感染、住院时间无影响,值得推广。
Objective To investigate the value of applying closed continuous negative pressure drainage in preventing postoperative complications of inguinal hernia. Methods The clinical data of 107 adult male patients diagnosed with inguinal giant hernia （incarcerated 16 cases, non-incarcerated 91 cases） undergoing tension-free hernioplasty using the Ultrapro Hernia System （UHS） between April 2011 and June 2016 in our hospital were retrospective analyzed. Prophylactic use of antibiotics was not adopted except patients with incarcerated hernia, diabetes, or elderly. Multi-lateral hole plasma drainage tube were used in 61 patients, 46 cases without indwelling plasma tube. The postoperative scrotum pain, scrotal hematoma, scrotal effusion, and incision infection of two groups patients were observed. Results Of the 61 patients with plasma drainage, the mean drainage time was 2 days, the longest was 5 days. Postoperative scrotal pain was found in 2 cases （3.3%） without scrotal hematoma or scrotal effusion. Of the 2 patients, the drainage of 1 case was obstructed, the drainage was extubated and the patient was cured and discharged after 5 days by sucking the drainage tube using empty needle. The average hospital stay in this group was 4 days. Of the 46 patients without plasma drainage, 7 patients （15.2%） suffered scrotal pain, 7 patients （15.2%） suffered scrotal hematoma. The average hospital stay was 6 days. The incidence of scrotal pain and scrotal hematoma was significantly higher in patients without plasma drainage than those with drainage （P〈0.05）. The condition of scrotal hematoma would be improved after 1-3 times outpatient dressing change and repeated hematoma sucking. One case was not improved after repeated suction, the condition was improved after scrotum incision, drainage, and dressing. Conclusion Closed continuous negative pressure drainage potentially prevents oblique hernia pain and scrotal hematoma without increasing the incidence of incision infection or hospitalization time.
出处
《中国普外基础与临床杂志》
CAS
2017年第7期854-857,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
腹股沟斜疝
阴囊血肿
血浆管
引流
oblique inguinal hernia
scrotum hematoma
plasma tube
drainage
