腹壁切口疝并发肠梗阻的易感因素分析及防治措施

目的探讨腹壁切口疝并发肠梗阻的易感因素及防治措施。 方法选取2013年2月至2018年10月，甘肃省人民医院收治的52例腹壁切口疝患者为研究对象，回顾性分析其临床资料，根据患者术后是否并发肠梗阻分为发生肠梗阻组（30例）与未发生肠梗阻组（22例）。比较2组患者一般资料及围术期相关指标，筛选出肠梗阻发生的易感因素，总结其防治措施。 结果发生肠梗阻组与未发生肠梗阻组在性别、是否合并急慢性支气管炎、是否合并前列腺炎方面比较，差异无统计学意义（P<0.05）。2组在年龄、手术类型、术前营养状况、切口类型、愈合类型、合并腹水及合并便秘者方面比较，差异无统计学意义（P>0.05）。发生肠梗阻组患者经治疗后腹痛消失时间为（3.40±1.78）d、腹胀消失时间为（4.24±1.57）d、排气时间为（5.96±1.61）d、进食流质时间为（6.95±2.02）d、胃肠减压引流量为（315.21±106.52）ml/d、平均住院时间为（14.59±2.63）d。 结论腹壁切口疝并发肠梗阻的易感因素为男性、合并急慢性支气管炎或前列腺炎，但肠梗阻经及时干预治疗后患者症状及体征均得以显著改善，提示重视易感因素的控制、及早给予治疗是防治肠梗阻的关键。

Analysis of the susceptible factors of abdominal wall incisional hernia complicated with intestinal obstruction and its prevention and control measures

ObjectiveTo explore the susceptible factors of abdominal wall incisional hernia complicated with intestinal obstruction and its prevention and control measures. Methods52 patients with incisional hernia admitted to Gansu provincial people's hospital from February 2013 to October 2018 were selected as the research objects. Their clinical data were retrospectively analyzed. According to whether the patients complicated with intestinal obstruction after operation, they were divided into intestinal obstruction group (n=30) and no intestinal obstruction group (n=22). The general data and perioperative indexes of the two groups were compared, the susceptible factors of intestinal obstruction were screened out and the preventive and therapeutic measures were summarized. ResultsThere were differences in gender, acute and chronic bronchitis and prostatitis between intestinal obstruction group and no intestinal obstruction group. There was no significant difference between the 2 groups in terms of age, type of surgery, preoperative nutritional status, type of incision, type of healing, complicated with ascites and constipation (P>0.05). In the patients with intestinal obstruction, the disappearance time of abdominal pain was (3.40±1.78) days, the disappearance time of abdominal distension was (4.24±1.57) days, the exhaust time was (5.96±1.61) days, the time of fluid intake was (6.95±2.02) days, the gastrointestinal decompression and drainage flow was (315.21±106.52) ml/day, and the average hospitalization time was (14.59±2.63) days. ConclusionThe susceptible factors of abdominal incisional hernia complicated with intestinal obstruction were male, complicated with acute and chronic bronchitis or prostatitis, but the symptoms and signs of patients with intestinal obstruction were significantly improved after timely intervention treatment. It is suggested that the key to prevent and treat intestinal obstruction is to pay attention to the control of susceptible factors and to give treatment as early as possible.