补片修补腹壁切口疝的临床应用

目的探讨腹壁切口疝的治疗。方法回顾性分析150例腹壁切口疝患者的临床资料。（1）肌腱膜上补片置入手术（ONLAY）126例；（2）筋膜前（腹膜前）、肌下补片置入手术（SUBLAY）4例；（3）缺损处直接补片置入途径（INLAY）13例；（4）腹膜腔内补片置入术（Introperitonealsite）7例。结果平均年龄58．5岁，女性占52．5％。上腹部切口36％，下腹部切口占64％。全部采用合成材料修补。聚丙烯材料130例，聚四氟乙烯-聚丙烯双面材料16例，强生Proceed补片4例，开腹手术143例，腹腔镜手术7例。复发3例，手术复发率为2％。结论ONLAY手术安全可靠，复发率低，是可以接受的切口疝修补方法，避免伤口感染，防治腹内压升高，促进伤口愈合，保证缝合质量是预防切口疝关键。

Tension-free hernia repair manner in the treatment of patients with incisional hernia of abdominal wall

Objective To discuss the Tension-free hernia repair manner treatment of incisional henia at site of abdominal wall. Methods 150 patients with incisional hernia were treated with a tension-free manner of hernia repair by using synthetic material. 126 patients with ONLAY ;4 patients with SUBLAY ;13 patients with INLAY ;7 patients with Introperitoneal site. Results All operations were successfully. 130 patients with Polypropylene Malex. 16 patients with Expanded Polytetrafluoroethylene. 4 patients with Proceed mesh. 7 patients of laparoscopic approach to mesh repair of abdominal incisional hernia. 150 patients were repaired with synthetic material and their recurrent rate was 2%. Conclusions ONLAY repair of incisional hernia of abdominal wall with synthetic material mesh was a safe and superior method, especially for those with larger abdominal wall hernias.