CAJ | 학술논문

目的探讨腹股沟疝无张力修补术后补片感染的预防和再手术时机及方法.方法回顾性分析2003年1月至2012年12月中国医科大学附属盛京医院收治的18例腹股沟疝无张力修补术后补片感染患者的资料.其中Lichtenstein无张力修补13例,疝环填充式无张力修补5例.应用聚丙烯补片修补者16例,膨体聚四氟乙烯补片修补者2例.根据感染程度、补片材料进行相应处理.开放换药未见好转后行再手术治疗.术后均一期缝合,完全去除补片者3例,术后留置引流管;部分去除补片者15例,予以双套管冲洗负压吸引.结果补片感染的18例患者均经再手术治愈出院.无围手术期死亡,手术后无疼痛、阴囊水肿及尿潴留.其中16例一期愈合,2例二期愈合.随访6个月至3年,18例患者切口愈合良好,出院后无感染及复发.结论腹股沟疝无张力修补术后补片感染的治疗以预防为主,根据感染类型及补片材料选取不同的治疗方式.
목적 탐토복고구산무장력수보술후보편감염적예방화재수술시궤급방법.방법 회고성분석2003년1월지2012년12월중국의과대학부속성경의원수치적18례복고구산무장력수보술후보편감염환자적자료.기중Lichtenstein무장력수보13례,산배전충식무장력수보5례.응용취병희보편수보자16례,팽체취사불을희보편수보자2례.근거감염정도、보편재료진행상응처리.개방환약미견호전후행재수술치료.술후균일기봉합,완전거제보편자3례,술후류치인류관;부분거제보편자15례,여이쌍투관충세부압흡인.결과 보편감염적18례환자균경재수술치유출원.무위수술기사망,수술후무동통、음낭수종급뇨저류.기중16례일기유합,2례이기유합.수방6개월지3년,18례환자절구유합량호,출원후무감염급복발.결론 복고구산무장력수보술후보편감염적치료이예방위주,근거감염류형급보편재료선취불동적치료방식.
Objective To investigate the prevention and the timing of reoperation and treatment of mesh infection after tension-free herniorrhaphy for inguinal hernia.Methods There were 18 mesh infections admitted from Jan.2003 to Dec.2012.Originally 13 cases were treated by Lichtentein repair,5 cases by mesh plug.Flat knitted polypropylene was used in 16 cases,polytef in 2 cases.Meshes were completely removed in 3 cases,partially removed in 15 cases.Tube drainage and suction were used and incision was sutured one stage.Results All the patients were reoperated and cured,with no perioperative death,no pain,no scrotal edema and urinary retention.16 cases were healed by first intention,the other 2 cases with delayed healing.Patients were followed up from 6 months to 3 (1.8 ± 0.4) years,with no recurrence of hernia and wound infection.Conclusions Treatment of mesh infection after tension-free herniorrhaphy for inguinal hernia relies mainly on prevention.Reoperation and mesh removal offers a chance of healing for cases intractable to conservative therapy.