巨大腹壁疝修补术中应用主动减容手术对腹腔内高压及预后的影响。

回顾性分析2015年1月至2017年8月，广元市中心医院就诊的40例巨大腹壁疝患者临床资料，患者均行巨大腹壁疝修补术联合主动减容手术。记录围术期及术后恢复相关指标、并发症及疝复发情况，并比较手术前后膀胱内压力变化。

所有患者均顺利完成手术，切除肠管长度（243.34±33.40）cm，拆线后手术切口均达到一级愈合。术后总并发症发生率为30.00%，随访9～12个月，疝复发率为5.13%。与术前比较，术后膀胱内压力明显降低[（11.19±1.84）cm H₂O vs（19.78±2.32）cm H₂O，P<0.05]。

巨大腹壁疝修补术联合主动减容手术切除部分网膜/肠管等脏器，可明显降低患者腹腔内高压，改善患者预后。

To explore the influence of active volume reduction surgery on intra-abdominal hypertension and prognosis in giant abdominal wall hernia repair.

The clinical data of 40 patients with giant abdominal wall hernia treated in Guangyuan central hospital from January 2015 to August 2017 were retrospectively analyzed, all patients underwent giant abdominal wall hernia repair combined with active volume reduction surgery. The perioperative and postoperative recovery related indicator, complications and recurrence were recorded, the changes of intravesical pressure before and after surgery were compared.

All patients underwent surgery successfully, and the length of the intestine removed were (243.34±33.40) cm, the surgical incision healed up after the suture removal. The total postoperative complication rate was 30.00%, the recurrence rate of hernia was 5.13% during 9~12 months of follow-up. Compared with index of preoperative, postoperative intravesical pressure significantly reduced [(11.19±1.84) cm H₂O vs (19.78±2.32) cm H₂O, P<0.05].

Giant abdominal wall hernia repair combined with active volume reduction surgery to remove some of the omentum/intestinal tube and other organs, can significantly reduce the intra-abdominal hypertension and improve the prognosis of patients.