【摘要】：目的：研究的目的是證實(shí)腹腔鏡下腹壁切口疝修補(bǔ)手術(shù)方式的安全性、療效及可行性。方法：回顧性對(duì)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例患者采用腹腔鏡下腹壁切口疝修補(bǔ)術(shù),90例患者采用肌筋膜前放置補(bǔ)片修補(bǔ)術(shù)(Onlay)。觀察兩組的術(shù)中出血量,手術(shù)時(shí)間、術(shù)后下床活動(dòng)和術(shù)后排氣時(shí)間、術(shù)后住院天數(shù)及并發(fā)癥的差異。結(jié)果：在年齡、性別,體重指數(shù)(BMI)、切口疝部位、切口類型、缺損大小、合并癥上兩組無顯著性差異(P0.05)。腹腔鏡組平均手術(shù)時(shí)間94.12min,平均術(shù)中出血量16.25ml,術(shù)后平均下床活動(dòng)時(shí)間1.26天,術(shù)后平均排氣時(shí)間1.29天,術(shù)后無一例患者出現(xiàn)血清腫及切口感染,有9例患者術(shù)后給予止痛藥物。肌鞘前置補(bǔ)片修補(bǔ)組平均手術(shù)時(shí)間132.77min,平均出血量55.7ml,術(shù)后平均下床活動(dòng)時(shí)間1.8d；術(shù)后平均排氣時(shí)間1.6天,有7例患者術(shù)后出現(xiàn)切口感染,有62例患者術(shù)后給予止痛藥物。兩組在手術(shù)時(shí)間、術(shù)中出血量、術(shù)后平均下床活動(dòng)時(shí)間,術(shù)后排氣時(shí)間、術(shù)后疼痛上有顯著性差異(P0.05).腹腔鏡組,隨訪3-,52個(gè)月,失訪4例,隨訪68例,有3例患者術(shù)后復(fù)發(fā),復(fù)發(fā)率4.41%。肌鞘前置補(bǔ)片修補(bǔ)組,隨訪3-52個(gè)月,失訪5例,隨訪85例,有4例術(shù)后復(fù)發(fā),復(fù)發(fā)率4.70%,差異無統(tǒng)計(jì)學(xué)意義。討論：腹腔鏡下腹壁切口疝修補(bǔ)手術(shù)方式在住院天數(shù)、術(shù)后恢復(fù)時(shí)間、術(shù)后疼痛、術(shù)后切口感染、術(shù)后切口并發(fā)癥的發(fā)生率方面明顯優(yōu)異開放式腹壁切口疝修補(bǔ)手術(shù)方法,是一種安全有效的手術(shù)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.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R656.24

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