目的

探讨腹壁巨大切口疝的特点及围手术期处理临床经验。

方法

对我院2003年1月至2008年1月间诊治的21例巨大腹壁切口疝患者的临床资料进行回顾性分析。

结果

21例患者疝环直径10～23 cm，平均（14.4±5.2）cm，3例患者疝囊容积与腹腔容积的之比>20%。11例患者术前存在腹内压增高因素。16例患者术前采用腹带加压捆扎方法，5例患者采用人工气腹法行腹腔扩容，2例放弃手术。引流管多在术后4～7 d拔除，平均（5.4±1.6）d。2例发生皮下积液，腹带加压束腹2周，无切口感染或补片排斥反应，无围手术期死亡。14例患者获得随访，复发1例。

结论

对腹壁巨大切口疝患者应加强围手术期评估和准备，提高手术的安全性。

Objective

To evaluate the clinical experience of perioperative management for huge abdominal incisional hernia.

Methods

Twenty-one patients with huge incisional hernia treated in our hospital from Jan.2003 to Jan.2008 were analyzed retrospectively.

Results

The hernial diameter was 10-23 (14.4±5.2)cm,the percentage of the contents of the sac defined and the abdominal contents that have lost domain in 3 patients are more than twenty percent. Evidence increase of intraabdiminal pressure occurred in 11 patients. Preoperative pressure abdominal belt and induced pneumoperitoneum were used in 16 and 5 patients,respectively.The operation was aborted in 2 patients.Draining ducts were extracted during 4-7(5.4±1.6)days postoperatively.2 patients occurred subcutaneous dropsy.All patients use abdominal belt for two weeks postoperatively.No incisional infection or mesh rejection occurred.One recurrent case was found during the postoperative follow-up period.

Conclusion

Perioperative evaluation and management is the most important for patients with huge abdominal incisionalhernia.