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【摘要】 目的 探討腹腔鏡切口疝修補(bǔ)術(shù)與開放式切口疝修補(bǔ)術(shù)治療腹壁切口疝的療效。方法 90例腹壁切口疝患者 ，采用隨機(jī)數(shù)字表法分為對(duì)照組 （47例 ）和觀察組 （43例 ）。對(duì)照組進(jìn)行開放式切口疝修補(bǔ)術(shù) ，觀察組進(jìn)行腹腔鏡切口疝修補(bǔ)術(shù)。比較兩組患者的治療效果 ，手術(shù)實(shí)施時(shí)間、術(shù)后抗生素使用時(shí)間、術(shù)后住院時(shí)間 ，手術(shù)前后生活質(zhì)量評(píng)分及應(yīng)激指標(biāo) ，并發(fā)癥發(fā)生情況。結(jié)果 觀察組患者的治療總有效率 97.67%顯著高于對(duì)照組的 72.34%，差異具有統(tǒng)計(jì)學(xué)意義 （ P<0.05）。觀察組患者手術(shù)后的生活質(zhì)量評(píng)分、腎上腺素水平、去甲腎上腺素水平， 手術(shù)實(shí)施時(shí)間、術(shù)后抗生素使用時(shí)間、術(shù)后住院時(shí)間均優(yōu)于對(duì)照組 ，差異具有統(tǒng)計(jì)學(xué)意義 （ P<0.05）。觀察組患者的并發(fā)癥發(fā)生率為 9.30%， 低于對(duì)照組的 27.66%， 差異具有統(tǒng)計(jì)學(xué)意義 （ P<0.05）。結(jié)論 腹壁切口疝患者行腹腔鏡切口疝修補(bǔ)術(shù)療效明顯 ，可更好的改善生活質(zhì)量、應(yīng)激指標(biāo)， 加速康復(fù)， 減少相關(guān)并發(fā)癥的發(fā)生。

【關(guān)鍵詞】 腹腔鏡切口疝修補(bǔ)術(shù);開放式切口疝修補(bǔ)術(shù);腹壁切口疝

DOI：10.14163/j.cnki.11-5547/r.2019.03.003

【Abstract】 Objective To discuss the efficacy of laparoscopic incisional hernia repair and open incisional hernia repair in the treatment of abdominal incisional hernia. Methods A total of 90 patients with abdominal incisional hernia were divided by random number table method into control group （47 cases） and observation group （43 cases）. The control group was treated with open incisional hernia repair， and the observation group was treated with laparoscopic incisional hernia repair. Comparison were made on treatment effect， operative implementation time， postoperative antibiotic use time， postoperative hospitalization time， quality of life scores and stress indicators before and after operation and occurrence of complications between the two groups. Results The observation group had significantly higher total treatment effective rate as 97.67% than 72.34% in the control group， and the difference was statistically significant （P<0.05）. After operation， the observation group had better quality of life score， adrenaline and norepinephrine levels， operative implementation time， postoperative antibiotic use time， postoperative hospitalization time than the control group， and the difference was statistically significant （P<0.05）. The observation group had lower incidence of complications as 9.30% than 27.66% in the control group， and the difference was statistically significant （P<0.05）. Conclusion Laparoscopic incisional hernioplasty provides obvious efficacy for patient with abdominal incisional hernia， and it can better improve the quality of life， stress indicators， accelerate recovery and reduce the occurrence of related complications.

【Key words】 Laparoscopic incisional hernia repair; Open incisional hernia repair; Abdominal incisional hernia

腹壁切口疝在臨床發(fā)生率較高 ，是腹部手術(shù)常見的并發(fā)和觀察組 （43例）。觀察組中男 26例， 女 17例;年齡 32～75歲 ， 癥 ，尤其是術(shù)后有切口感染的患者 ，往往腹壁切口疝的發(fā)生平均年齡 （50.22±8.26）歲;切口疝在腹部中間 34例 ， 在邊率也較高。以往對(duì)于腹壁切口疝的治療一般采用開放式人工緣區(qū)域 9例;復(fù)發(fā)時(shí)間距離上次手術(shù) 5～17個(gè)月 ，平均時(shí)間補(bǔ)片進(jìn)行修補(bǔ)或者采用縫合修補(bǔ)手術(shù)進(jìn)行治療[1]。本研究分（7.22±3.26）個(gè)月。對(duì)照組男 29例， 女 18例;年齡 32～76歲 ， 析腹腔鏡切口疝修補(bǔ)術(shù)與開放式切口疝修補(bǔ)術(shù)治療腹壁切口平均年齡 （50.65±8.45）歲;切口疝在腹部中間 37例 ， 在邊疝的療效， 報(bào)告如下。 緣區(qū)域 10例;復(fù)發(fā)時(shí)間距離上次手術(shù) 5～17個(gè)月 ，平均時(shí)間1 資料與方法 （7.25±3.25）個(gè)月。兩組患者的一般資料比較 ，差異無(wú)統(tǒng)計(jì)學(xué)