使用人工合成植入物对游离和绞窄性疝气患者进行手术治疗后的临床特征和并发症发生频率评估

A. Lyzikov, E. L. Artyushkov, Y. Y. Doroshko, M. Kaplan
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摘要

目的对使用人工合成假体进行无张力疝成形术的不同定位游离和绞窄性疝患者术后并发症的发生频率进行临床评估和对比分析。对2018年至2022年期间因不同定位的疝而接受无张力疝成形术的965名住院患者的病历进行回顾性分析。研究结果使用 MS Excel 和统计分析软件包 "Statistica v. 10.0 "进行应用统计处理。以 P < 0.05 为差异有统计学意义。研究显示,绞窄性疝气患者在无张力疝成形术后的术后并发症发生率为 15.8%。同时,绞窄性疝气患者 "嵌顿 "疝成形术后的并发症发生率高于游离性疝气患者。术后腹股沟疝气受损患者出现术后并发症的频率是术后腹股沟疝气游离患者的 8.3 倍。术后出现血清肿和术后伤口浸润等并发症的比例分别为 10.5%和 5.2%。疝成形术后出现并发症的患者的住院治疗时间是无并发症患者的 2.6 倍(P < 0.05)。术后,15.8%的绞窄性疝气患者出现并发症,1.5%的游离性和不可复性疝气患者出现并发症。临床上发现的术后并发症有血清肿、术后伤口浸润、结扎瘘、阴囊血肿、睾丸炎、术后伤口脓肿等。
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Clinical characteristics and assessment of the frequency of complications after surgical treatment of patients with free and strangulated hernias using synthetic implants
Objective. To give a clinical assessment and conduct a comparative analysis of the frequency of postoperative complications in patients with free and strangulated hernias of various localizations after tension-free hernioplasty using synthetic implants.Materials and methods. A retrospective analysis of 965 medical records of inpatient patients who underwent tension-free hernioplasty for hernias of various localizations in the period from 2018 to 2022 was carried out. The results of the study were processed using applied statistics using MS Excel and a software package for statistical analysis “Statistica v. 10.0”. Statistically significant differences were considered at p < 0.05.Results. The study revealed that in the postoperative period after tension-free hernioplasty in patients with strangulated hernias, the complication rate was 15.8%. At the same time, the frequency of complications was higher after “onlay” hernioplasty in patients with strangulated hernias than in patients with free hernias. The frequency of postoperative complications in patients with impaired postoperative ventral hernias is 8.3 times higher than in patients with free postoperative ventral hernias. In the postoperative period, complications such as seroma and infiltration of the postoperative wound were detected in 10.5 and 5.2% of cases in patients with strangulated hernias. The duration of inpatient treatment for patients with complications after hernioplasty is 2.6 times longer compared to patients without complications (p < 0,05).Conclusion. In the postoperative period, in patients with strangulated hernias, the incidence of complications was observed in 15.8% of cases, and in patients with free and irreducible hernias in 1.5% of cases. Clinically, such postoperative complications as seromas, infiltrates of the postoperative wound, ligature fistulas, scrotal hematoma, orchitis, abscess of the postoperative wound were identified.
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