创伤性腹壁疝的诊治经验

目的 探讨创伤性腹壁疝的临床诊断标准和治疗方案.方法 回顾性分析1971-2004年收治的11例创伤性腹壁疝的临床资料.皮下型疝8例,其中嵌顿型疝2例,难复性疝1例;肌间隙型疝2例,其中嵌顿和绞窄1例;腹膜后型1例.11例中单纯性疝3例,伴腹内其他脏器损伤的复合性疝8例.结果 症状出现至就诊时间3 h至5个月,11例中8例误诊.5例错误选择切口,1例误将疝出肠襻切开.误诊8例中3例修补失败,2例未发现缺损行二次手术.结论 对创伤性腹壁疝只有做出正确的诊断,选择正确的手术时机,确定恰当的手术切口,制定合理的修补方法,方可获得良好的治疗效果.

Diagnosis and treatment of traumatic abdominal wall hernia

Objective To analyze the causes of misdiagnesis and mistreatment of traumatic abdominal hernia. Methods In this study,11 cases of traumatic abdominal hernia admitted during 1971 to 2004 were retrospectively analyzed.Hernia located subcutaneously in 8 cases including incarcerated hernia in 2 csses.Hernia located intermuscularly in 2 cases with one case being incarcerated.and the other strangulated.One located retroperitoneally.Among the 11 cases,3 were simple hernia,8 were complicated with injuries of other organs. Results Eight cases were misdiagnosed,5 were operated on with wrong incision,and in one case the herniated intestinal loop,mistaken as hematoma,was incised.All these 5 cases underwent a second surgery due to failure in repairing the hernia. Condusion For traumatic abdominal wall hernia,correct diagnosis,the correct timing of operation and an appropriate incision chosen insure good therapeutic results.