中国实用外科杂志

中国实用外科杂志

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腹腔镜技术在腹股沟疝无张力修补术后感染治疗中应用价值研究

曹金鑫，王明刚，陈    杰，刘雨辰，邹振玉，申英末，朱熠林   

  1. 首都医科大学附属北京朝阳医院疝和腹壁外科，北京  100043
  • 发布日期:2020-07-23

  • Published:2020-07-23

摘要： 目的    探讨腹腔镜技术在腹股沟疝无张力修补术后感染治疗中的应用价值。方法    回顾性分析2015年3月至2018年12月首都医科大学附属北京朝阳医院疝和腹壁外科收治的行感染清创手术的124例无张力腹股沟疝修补术后感染病人的临床资料，其中18例直接行开放清创术，106例行腹腔镜探查。结果    106例行腹腔镜探查的病人中43例病人腹股沟区存在组织粘连并在腹腔镜下完成粘连分离；8例病人在腹腔镜下完成清创操作，98例病人腹腔镜探查后联合开放清创术。所有病例手术时间为（67.6±34.9）min。术后3例病人切口愈合不良，对症治疗后痊愈，术后随访1年，22例病人再次感染入院治疗，4例病人腹股沟疝复发再次入院行腹腔镜腹股沟疝修补术，无病人出现术后慢性疼痛等其他并发症。 结论    对于腹股沟疝修补术后发生感染的病人，腹腔镜技术安全有效，能够减少病人手术创伤和痛苦，具有一定的临床价值。

关键词: 腹股沟疝, 感染, 腹腔镜, 清创, 探查

Abstract: Effect of the laparoscopic technique used in treatment of postoperative infection after inguinal hernia tension-free repair        CAO Jin-xin，WANG Ming-gang，CHEN Jie，et al. Department of Hernia and Abdominal Wall Surgery，Beijing Chao-Yang Hospital，Capital Medical University，Beijing 100043，China
Corresponding authors：WANG Ming-gang，E-mail：wmgonly@126.com；CHEN Jie，E-mail：chenjiejoe@sina.com
Abstract    Objective    To discuss the therapeutic effect and application value of laparoscopic technique used in infection after inguinal hernia tension-free repair. Methods    The clinical data of 124 postoperative infection patients accepted infection debridement between March 2015 to December 2018 in Department of Hernia and Abdominal Wall Surgery，Beijing Chao-Yang Hospital，Capital Medical University were analyzed retrospectively. Laparoscopic technique was used in 106 patients, and other 18 patients accepted open debridement only. Results    43 cases with intraperitoneal adhesions was found and finished separation. 8 laparoscopic debridement operations were proformed and the others combined with open debridement. The average operation time was 67.6±34.9 min. There were 3 patients with poor incision healing and were recovered after treatment. Postoperative follow up was 1 year and 22 patients were hospitalized for reinfection. Four recurrence patients accepted TAPP. There was no chronic pain. Conclusion Laparoscopic technique is a safe and effective approach which could reduce the surgical trauma and pain of patients，and it has certain clinical value in treatment of infection after inguinal hernia tension-free repair.

Key words: inguinal hernia, infection, laparoscope, debridement, exploration