腹腔镜成人疝修补术后复发原因分析.docVIP

腹腔镜成人疝修补术后复发原因分析 　　[摘要] 目的 探究腹腔镜成人疝修补术后复发的原因。 方法 回顾性分析整群选取的该院2011年3月―2014年3月收治的299例腹腔镜成人疝修补术患者临床资料，统计复发情况，并分析疝修补术复发原因。 结果 经研究分析发现，患者手术复发率为3.68%（12/299），复发原因包括2例补片固定不佳导致移位，1例补片固定时留有空隙较大，1例由于手术后感染，2例由于疝囊颈缝扎位置欠佳，使得存在漏洞，进而复发，2例内环口水肿，1例内环口缝线断裂，1例直疝误诊为斜疝，1例复发由于补片的材料及形状的影响，1例补片位置不合理；经在手术治疗后，患者病情均得以控制，逐渐好转，1年内未见复发。 结论 腹腔镜成人疝修补术后存在一定复发几率，术后复发对患者病情影响较大，复发原因较多，应加强对复发原因的分析，明确复发原因后再次手术治疗控制患者病情，以确保患者健康安全。 　　[关键词] 腹腔镜成人疝修补术；复发原因；复发率；再手术 　　[中图分类号] R656 [文献标识码] A [文章编号] 1674-0742（2016）02（a）-0078-02 　　Cause Analysis of Recrudescence after Laparoscopy Adult Herniorrhaphy 　　WANG Yong-xin 　　Department of general surgery， Dongwu Integrated traditional Chinese and Western Medicine Hospital， Suzhou， Jiangsu Province， 215007 China 　　[Abstract] Objective To discuss the cause of recrudescence after laparoscopy adult herniorrhaphy. Methods The clinical data of 299 cases of patients with laparoscopy adult herniorrhaphy treated in our hospital from March 2011 to March 2014 were retrospectively analyzed and the recrudescence condition was given statistics， the recrudescence causes of herniorrhaphy were analyzed. Results The research and analysis showed that the surgical recrudescence rate of patients was 3.68%（12/299）， the recrudescence causes included 2 cases with displacement caused by poor patch fixation， 1 case with a larger gap when the patch was fixed， 1 case with infection after operation， 2 cases with loopholes caused by the poor hernia sac neck suture location leading to further recrudescence， 2 cases with ？internal ring edema， 1 case with internal ring suture fracture， 1 case of direct hernia misdiagnosed as indirect hernia， 1 case with recrudescence influenced by the material and shape of the patch， 1 case with unreasonable patch location， after treatment， the patient’s condition was controlled and gradually improved， the recrudescence didn’t occur in 1 year. Conclusion The laparoscopy adult herniorrhaphy has a certain recrudescence risk， the postoperative recrudescence has a b