目的 探讨超声容积断层自动扫描（UVAS）在老年腹壁切口疝诊断、分类和治疗中的应用价值。方法 采用前瞻性、随机、单盲研究方法，以2023年8月至2024年12月复旦大学附属华东医院疝和腹壁外科招募的46例老年腹壁切口疝病人为研究对象，共56个腹壁缺损（疝环），使用UVAS测量疝环宽度、面积和疝囊体积（HSV），与CT测得的HSV进行一致性评价，将基于超声图像的切口疝分类诊断与手术诊断进行比较。结果 UVAS和CT测量HCV数值比率的平均数为1.007，接近1，仅1.79%（1/56）的点在95%一致性界限（0.997-1.026）以外，可认为两种检查测量HSV具有较好的一致性。根据腹壁缺损的位置和宽度，UVAS术前分类与术后诊断的符合率为94.6%、98.2%，达成良好的一致性（K=0.86，95%CI 0.718-0.996；K=0.95，95%CI 0.887-0.999）。在大切口疝和巨大切口疝中，补片尺寸是UVAS测量腹壁缺损面积的2~9倍。结论 UVAS可准确诊断并测量腹壁切口疝的疝环宽度、面积和HSV，进行术前分类定位，具有无辐射危害和即时提供报告的优势，为老年腹腔切口疝病人术前全面评估提供详细可靠的客观数据及影像资料。

Objective To explore the application of ultrasonic volume auto-scan (UVAS) in the classification, diagnosis, and treatment of abdominal incisional hernia. Methods Using a prospective, randomized, and single-blind study design, The study subjects were 46 elderly patients with abdominal wall incisional hernia recruited from the Department of Hernia and Abdominal Wall Surgery, Huadong Hospital Affiliated to Fudan University, from August 2023 to December 2024. totally 56 abdominal wall defects (hernia rings), were recruited based on inclusion criteria. UVAS was employed to measure the width, area, and hernia sac volume (HSV) of the hernia rings. The consistency between these measurements and the HSV determined by CT was evaluated. Additionally, the ultrasound-based classification diagnosis of incisional hernia was compared with the surgical diagnosis. Results The average ratio of UVAS and CT measurements for HSV values was 1.007, which was close to 1. Only 1.79% (1/56) of the points fall outside the 95% consistency bounds 0.997-1.026, which showed good consistency between the two methods in measuring HSV. Based on the location and width of the abdominal wall defect, UVAS preoperative classification diagnosis showed a good accuracy rate (94.6%, 98.2%), achieving good consistency with postoperative diagnosis (K=0.86, 95%CI 0.718-0.996; K=0.95, 95%CI 0.887-0.999). In large and giant incisional hernias, the mesh size is 2 to 9 times the area of the abdominal wall defect measured by UVAS. Conclusion UVAS could accurately diagnose and measure the width, area, and HSV of abdominal incisional hernia, perform preoperative classification and localization, have the advantages of no radiation hazard and instant report provision and provide detailed and reliable data and imaging information for comprehensive preoperative evaluation of elderly patients with incisional hernia.