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  • Published:2020-07-23

腹壁外科桥接手术常见并发症预防和处理

周建平,任    峰,周静瑜   

  1. 中南大学湘雅二医院老年外科,湖南长沙 410011

Abstract: Prevention and management of common complications of bridging operation in abdominal wall surgery        ZHOU Jian-ping,REN Feng,ZHOU Jing-yu. Department of Geriatrics Surgery,the Second Xiangya Hospital,Central South University,Changsha 410011,China
Corresponding author:ZHOU Jian-ping,E-mail:392991429@
qq.com
Abstract    Repair of abdominal wall defect by artificial material bridging is commonly used in clinical surgery. Bridging is analogous to constructing a single structural aponeurosis to achieve structural and functional integrity of the abdominal wall. The key points of the bridging technology are shown below:(1)Maintaining moderate tension of the mesh. (2)Usage of the light-weight large-porous mesh. (3)Adequate drainage in front of the mesh. (4)Flattening and effective fixation of the mesh. The common intraoperative complication of bridging surgery is intestinal injury. As for postoperative complications,short-term ones include seroma,skin necrosis,incision dehiscence,mesh exposure and abdominal compartment syndrome,and long-term ones include mesh bulging,mesh infection and recurrence. Reasonable treatment of various problems that occur during and after bridging operation will contribute to the effective recovery of structure and function of abdominal wall for patients.

Key words: abdominal wall defect, surgical repair, bridging, complication

摘要: 人工材料桥接修复腹壁缺损是临床上经常采用的手术方式,桥接类似于构造一个结构单一的腱膜性结构,从而达到腹壁结构和功能上的完整。桥接的要点包括:(1)维持补片适度张力。(2)使用轻量型大网孔补片。(3)补片前充分引流。(4)铺平补片并确切固定。桥接手术常见的术中并发症为肠管损伤;术后常见的短期并发症为血清肿、皮肤坏死、切口裂开、补片外露、腹腔间室综合征;术后长期并发症为补片膨出、补片感染和复发。合理处理桥接手术术中及术后出现的各类问题,将有助于病人腹壁结构和功能的有效恢复。

关键词: 腹壁缺损, 手术修补, 桥接, 并发症