绞窄性腹外疝一期修补术的疗效探讨

目的探讨绞窄性腹外疝一期修补术的疗效。方法回顾分析2000年6月至2007年6月我科施行的41例绞窄性腹外疝手术的的临床资料，其中作单纯高位结扎的17例（结扎组），作一期修补术的24例（修补组）。结果两组无死亡病例，但术后切口感染有4例，发生在结扎组和修补组的均各为2例，两组的切口感染发生率无显著差异（P〉0．05）。疝复发共20例，其中结扎组是17例（复发率为100％），修补组是3例（复发率为12．5％），两组的复发率有显著性差异（P〈0．01）。所有复发病例均采用无张力疝修补术修补，痊愈出院，全部随访一年以上。无再复发。结论对绞窄性腹外疝的治疗，只要严格掌握手术适应证，围手术期合理使用抗生素，术中注意无菌操作和保护创面．一期疝修朴术亦可取得切口感染少及复发率低的良好效果。

Study of curative effect on the primary repair for strangulated abdominal external hernia

Objective To investigate the curative effect of primary repair for strangulate abdominal external berniua. Methods From June 2000 to June 2007, the clinical data of 41 cases with strangatated abdominal external hernia received operation were analyzed retrospectively. Among them,17 cases underwent simple high ligation of hernia sac(ligation group) and 24 cases underwent primary repair(repair group). Results There was no death in two groups.But postoperative incisional infection had 2 cases in each group. The incisional infection rate was no significan difference between two groups(P > 0.05). There were 20 cases with hernia recurrence in two groups after operation. Among them, 17 cases occured in simple high ligation group(recurronce rate was 100%) and 3 cases in primary repair group(recurrerce rate 12.5%). The recurrence rate had significant difference between two groups(P < 0.01). In the all recurrence cases, the tension-free hernia repair was done. No complications were found after operation. All cases were followed-up more than one year after discharge, and no secondary recurrence was found. Condusion So long as controlling strict operative indications, reasonable use of antibitics, attension of intraoperative aseptic manipulations and protecting surface of wound,the primary repair would get a less wound infection and lower recurrence rate for the treatment of strangulated abdominal external hernia.