切口腹疝的治疗技术综述

E. Lukoyanychev, S. G. Izmajlov, V. Emelyanov, O. S. Kolchina, A. Rotkov, M. N. Kiselyov
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引用次数: 1

摘要

目前,切口腹疝(IVH)的手术治疗仍然是一个重要的问题。据统计资料显示,25年来,术后腹疝患者数量增加了9倍以上。专家们每年都会为这个问题提供许多解决方案,外科医生必须在信息流中找到最佳的术后康复方法。使用学术研究数据库Google Scholar、CyberLeninka等来搜索相关文献。从这次审查中得出以下结论。IVH的病因是多因素的。目前尚无公认的基于证据的危险因素分级。IVH患者前腹壁疝修补方法的选择尚无统一的体系。同种异体移植材料的选择和疝修补的方法往往是个体化的。腹内压的临界值尚未明确,然而,所有作者都同意其监测应成为常规。亚埋入技术仍然是腱膜瓣整形手术的“金标准”,当亚埋入无法进行时,应采用嵌体。Onlay应该用作备用方法。在某些情况下,需要多种技术的组合。越来越多的腹腔镜作为辅助手段和治疗手段被引入体外受精的治疗中。基于腹壁解剖结构无控制分离的疝修补新方法的引入对手术技术提出了特殊要求:塑料材料、器械和技术支持、伤口闭合和药物支持,特别是在腹内压力和组织张力增加的情况下。我们可以使用嘧啶排(xymedon)药物来更好地植入网状种植体,并增加局部组织的阻力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
General views on treatment technologies for patients with incisional ventral hernia
Nowadays, the problem of surgical treatment of incisional ventral hernia (IVH) still remains significant. According to the statistical data, the number of patients with postoperative ventral hernias has increased by more than 9 times over the past 25 years. Experts offer many solutions to this problem every year and the surgeon have to find the best method of postoperative rehabilitation in the flow of information. Academic research databases Google Scholar, CyberLeninka and others were used to search for the relevant literature. The following conclusions were drawn from this review. The etiology of IVH is multifactorial. There is no generally accepted evidence-based gradation of risk factors. There is no unified system for selecting the method of hernia repair of the anterior abdominal wall in patients with IVH. The choice of allotransplant material and the method of hernia repair are often individual. The value of the critical level of intraabdominal pressure have not been specified, however, all authors agree that its monitoring should become routine. The sublay technique remains the "gold standard" of plastic surgery by aponeurotic flap, inlay should be used when sublay is impossible to perform. Onlay should be used as a reserve method. In some situations, combinations of techniques are required. More and more laparoscopy is being introduced in the treatment of IVH as an assistance and in therapy. The introduction of new methods of hernia repair based on the uncontrolled separation of the anatomical structures of the abdominal wall imposes special requirements on surgical technology: plastic material, instrumental and technical support, wound closure and pharmacological support, especially in conditions of increased intra-abdominal pressure and tissue tension. We can use medication of pyrimidine’s row (xymedon) for a better implantation of the mesh implant and to increase the resistance of local tissues.
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