腹腔镜腹壁切口疝修补术与肌鞘前置补片修补方法的临床对比研究

发布时间：2018-12-09 10:32

【摘要】：目的：研究的目的是证实腹腔镜下腹壁切口疝修补手术方式的安全性、疗效及可行性。方法：回顾性对比研究2010年6月至2014年10月在我科行162例腹壁切口疝患者,其中72例患者采用腹腔镜下腹壁切口疝修补术,90例患者采用肌筋膜前放置补片修补术(Onlay)。观察两组的术中出血量,手术时间、术后下床活动和术后排气时间、术后住院天数及并发症的差异。结果：在年龄、性别,体重指数(BMI)、切口疝部位、切口类型、缺损大小、合并症上两组无显著性差异(P0.05)。腹腔镜组平均手术时间94.12min,平均术中出血量16.25ml,术后平均下床活动时间1.26天,术后平均排气时间1.29天,术后无一例患者出现血清肿及切口感染,有9例患者术后给予止痛药物。肌鞘前置补片修补组平均手术时间132.77min,平均出血量55.7ml,术后平均下床活动时间1.8d；术后平均排气时间1.6天,有7例患者术后出现切口感染,有62例患者术后给予止痛药物。两组在手术时间、术中出血量、术后平均下床活动时间,术后排气时间、术后疼痛上有显著性差异(P0.05).腹腔镜组,随访3-,52个月,失访4例,随访68例,有3例患者术后复发,复发率4.41%。肌鞘前置补片修补组,随访3-52个月,失访5例,随访85例,有4例术后复发,复发率4.70%,差异无统计学意义。讨论：腹腔镜下腹壁切口疝修补手术方式在住院天数、术后恢复时间、术后疼痛、术后切口感染、术后切口并发症的发生率方面明显优异开放式腹壁切口疝修补手术方法,是一种安全有效的手术方式。
[Abstract]:Objective: to verify the safety, efficacy and feasibility of laparoscopic incisional hernia repair. Methods: a retrospective study of 162 patients with incisional hernia of abdominal wall was performed in our department from June 2010 to October 2014. Among them, 72 cases were treated with laparoscopic incisional hernia repair and 90 cases were treated with anterior myofascial patch repair (Onlay). The differences of intraoperative bleeding volume, operation time, postoperative movement out of bed and postoperative exhaust time, postoperative hospitalization days and complications were observed between the two groups. Results: there was no significant difference between the two groups in age, sex, body mass index (BMI),) site of incisional hernia, incision type, defect size and complication (P0.05). In the laparoscopy group, the mean operative time was 94.12 min, the average intraoperative bleeding was 16.25 ml, the average time of getting out of bed was 1.26 days, and the average time of exhaust was 1.29 days. Nine patients were treated with painkillers after operation. The average operation time was 132.77 minutes, the average blood loss was 55.7 ml, and the average time of getting out of bed was 1.8 days. The mean time of exhaust was 1.6 days after operation, 7 patients developed incision infection and 62 patients received painkillers. There were significant differences between the two groups in the time of operation, the amount of blood lost during operation, the average time of getting out of bed after operation, the time of exhaust after operation and the postoperative pain (P0.05). In the laparoscopic group, 3 cases were followed up for 3 months, 52 months, 4 cases were lost, 68 cases were followed up, 3 cases recurred after operation, the recurrence rate was 4.41%. In the muscle sheath repair group, there were 5 cases lost and 85 cases followed up for 3-52 months. 4 cases recurred after operation and the recurrence rate was 4.70. There was no significant difference between the two groups. Discussion: laparoscopic incisional hernioplasty for abdominal wall incisional herniorrhaphy is excellent in terms of hospital stay, postoperative recovery time, postoperative pain, postoperative wound infection, and the incidence of postoperative incision complications. It is a safe and effective operation method.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R656.24

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