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腹股沟嵌顿疝术后手术部位感染因素分析

杨林华,陈    涛,王    坚   

  1. 上海交通大学医学院附属仁济医院 普外科,上海200127
  • 发布日期:2012-11-29

  • Published:2012-11-29

摘要:

目的    探讨引起腹股沟嵌顿疝手术部位感染的危险因素。方法    回顾性分析上海交通大学医学院附属仁济医院普外科2005年1月至2010年12月经手术治疗的301例腹股沟嵌顿疝病人的临床资料及随访结果,其中伴有绞窄坏死者予以剔除。结果    术后近期(3个月内)全部随访,术后发生伤口血肿1例(0.3%),伤口积液8例(2.7%),伤口感染4例(1.3%),无深部补片感染,术后近期浅表切口手术部位感染与糖尿病(P=0.015)、嵌顿时间(P=0.005)、伤口积液(P=0.000)相关。远期随访病例226例,随访率75.1%,随访期6~72个月,平均随访时间34.2个月,3例复发,无伤口感染或深部补片感染。结论    腹股沟嵌顿疝术后近期切口手术部位感染的危险因素为合并糖尿病、嵌顿时间>24 h及切口积液;腹股沟嵌顿疝行无张力修补术是安全可行的。

关键词: 腹股沟嵌顿疝, 手术部位感染

Abstract:

Risk factors of surgical site infection after incarcerated inguinal hernia repair        YANG Lin-hua, CHEN Tao, WANG Jian. Department of General Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127,China
Corresponding author: WANG Jian,E-mail :dr_wangjian@yahoo.com.cn
Abstract    Objective    To investigate risk factors of surgical site infection after incarcerated inguinal hernia repair. Methods    The clinical data and follow-up of 301 cases of incarcerated inguinal hernia repair performed from January 2005 to December 2010 in Renji Hospital, Shanghai Jiao Tong University were analyzed retrospectively. Cases of intestinal necrosis were excluded. Results    All cases had short-term follow-up (3 month). There were 13 cases of postoperative complication including 1 case of localized hematoma(0.3%), 8 cases of seroma (2.7%)and 4 cases of superficial surgical site infection (1.3%). Diabetes(P=0.015), incarcerated time (P=0.005)and seroma (P =0.000)were related to superficial surgical site infection in short-term follow-up and no mesh infection was found. Among 226 cases (75.1%) of long-term follow-up (6-72 months), neither surgical site infection nor mesh infection was found, except for 3 cases of hernia recurrences. Conclusion    Surgical site infection rate in short-term is related to diabetes, incarcerated time (>24 hours) and seroma. Tension-free hernia repair is safe and feasible in incarcerated inguinal hernia.

Key words: incarcerated inguinal hernia, surgical site infection