中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (12): 2198-2200.doi: 10.3969/j.issn.1673-8225.2010.12.027

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

人工补片材料修补腹壁巨大切口疝：同一机构5年13例资料回顾

王玉彬   

  1. 辽宁医学院附属第一医院普外科，辽宁省锦州市  121001
  • 出版日期:2010-03-19 发布日期:2010-03-19
  • 作者简介:王玉彬，男，1964年生，辽宁省葫芦岛市人，汉族，1987年大连医科大学毕业，副主任医师，主要从事普外科工作。 qish.1977@yahoo.com.cn

Repair of huge incisional abdominal wall hernia using artificial patch: Data review of 13 cases in the same institute in 5 years

Wang Yu-bin   

  1. Department of General Surgery, First Affiliated Hospital of Liaoning Medical University, Jinzhou  121001, Liaoning Province, China
  • Online:2010-03-19 Published:2010-03-19
  • About author:Wang Yu-bin, Associate chief physician, Department of General Surgery, First Affiliated Hospital of Liaoning Medical University, Jinzhou 121001, Liaoning Province, China qish.1977@yahoo.com.cn

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摘要：

背景：腹部巨大切口疝是腹部术后治疗难题，近年来用聚丙烯和聚四丙烯复合切口疝补片修腹壁巨大切口疝已成为主要方法，临床已有很多成功和失败的范例。
目的:评价应用人工补片材料修补腹壁巨大切口疝5年13例资料的特点和应用安全性。
方法:于2000-01/2005-06收治术后巨大腹壁切口疝患者13例，男9例，女4例，平均年龄61岁。均为初次切口疝，疝环最大径为20 cm，平均16.1 cm。术前治疗合并症，沿原手术切口逐层切开皮肤及皮下组织，游离和松解疝囊周边黏连，显露疝环。游离完毕，回纳疝囊，将适当大小人工补片材料平铺在腹横筋膜与腹直肌后鞘之间，游离腹直肌前鞘腹侧至疝环外3 cm，将网片边缘间断缝合固定于前方的肌筋膜层以方便缝合固定补片。术后严密监测患者循环和呼吸功能变化。
结果与结论: 13例患者术后均恢复顺利，无严重并发症。有3例发生皮下积液，经穿刺抽吸，局部压迫等处理后完全吸收，全组患者随访1~3年，无复发。提示人造补片材料修复腹壁巨大切口疝安全有效。

关键词: 巨大切口疝, 腹壁, 人工补片, 生物相容性, 生物材料　

Abstract:

BACKGROUND: Huge incisional abdominal wall hernia is a puzzle after abdominal surgery. Recently, polypropylene and polytetrafluoroethene synthetic patch are widely used in repairing huge incisional abdominal wall hernia, and there are successful and failure cases in clinical treatment.
OBJECTIVE: To evaluate the data characteristics and safety of using artificial patch to repair huge incisional abdominal wall hernia of 13 cases in 5 years.
METHODS: From January 2000 to June 2005, 13 cases suffered huge incisional abdominal wall hernia after abdominal surgery were selected, including 9 males and 4 female, mean aged 61 years. The maximum diameter of hernial ring was 20 cm, mean 16.1 cm. The complication was treated before surgery, skin and subcutaneous tissue was incised, the synechia around hernial sac was removed and the hernial ring was exposed. After that, the artificial patch with suitable size was placed between transverse fascia and posterior sheath of rectus abdominis, and the anterior sheath of rectus abdominis was dissociated to 3-cm far from hernial ring. The edges of patch were fixed to muscular fasciae and sutured. The circulatory function and respiratory function changes were monitored after surgery.
RESULTS AND CONCLUSION: All the 13 cases were recovered smoothly without serious complications. Subcutaneous hydrops occurred in 3 cases, but cured by needle puncture aspiration and local compression. All the cases were followed up for 1-3 years, and there was no recurrence. The results demonstrated that it is safe and effective to repair huge incisional abdominal wall hernia using artificial patch.

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