目的

探讨低温等离子射频消融治疗腹壁疝术后补片感染的临床效果。

方法

选取2007 年1 月至2022 年3 月解放军总医院第四医学中心普通外科收治的56 例腹壁疝术后补片感染患者作为研究对象。将2007 年1 月至2013 年12 月使用电刀及锐器取出补片及清创的29 例腹壁疝术后补片感染患者纳入对照组；将2014 年1 月至2022 年3 月使用低温等离子射频消融技术取出补片及清创的27 例腹壁疝术后补片感染患者纳入试验组。比较2 组患者的手术时间、术后住院时间、切口甲级愈合发生率、细菌培养结果阳性率和不良反应发生率。

结果

试验组与对照组手术时间[（62.2±14.2）min 比（59.3±15.7）min]比较，差异无统计学意义（P＞0.05）；试验组术后住院时间（28.5±3.3）d 显著低于对照组（37.4±2.9）d，差异有统计学意义（P＜0.05）。试验组与对照组切口甲级愈合发生率[100%（27/27）比79.3%（23/29）]比较，差异有统计学意义（P＜0.05）。2 组术中细菌培养阳性率比较，差异均无统计学意义（P＞0.05），术后第5 天及第10 天，试验组细菌培养阳性率均显著低于相应时间点的对照组，差异均有统计学意义（P＜0.05）。试验组不良反应发生率为0%（27/27），显著低于对照组27.6%（8/29），差异有统计学意义（P＜0.05）。

结论

低温等离子射频消融可以减少术后住院时间，改善切口愈合等级、减少术后并发症并改善术后创面的细菌培养结果，可以作为感染补片取出的选择。

Objective

To investigate the clinical effect of low temperature plasma ablation technology in the treatment of mesh infection after abdominal wall hernia.

Methods

From January 2007 to March 2022, 56 patients with mesh infection after abdominal wall hernia surgery who were admitted to the department of the Fourth Center of the General Surgery Department of the First Medical Center of the PLA General Hospital were selected as the research objects.29 patients diagnosed as having mesh infection after abdominal wall hernia surgery that removed the mesh and debrided with electrocautery and sharp instruments from January 2007 to December 2013 were included in the control group; 27 patients diagnosed as having mesh infection after abdominal wall hernia surgery that removed the mesh and debrided with low temperature plasma ablation were included in the experimental group.The operation time and postoperative hospital stay, the incidence of grade A wound healing, the positive rate of bacterial culture results and the incidence of adverse reactions were compared between the two groups.

Results

The operation time of the experimental group and the control group were (62.2±14.2) min and (59.3±15.7) min respectively, and the difference was not statistically significant (P＞0.05).The postoperative hospital stay in the experimental group was (28.5±3.3) d significantly lower than that in the control group (37.4±2.9) d, and the difference was statistically significant (P＜0.05).The incidence of grade A wound healing in the experimental group and the control group was 100% (27/27) and 79.3% (23/29), respectively, and the difference was statistically significant (P＜0.05).There was no statistical significance in the positive rate of bacterial culture between the two groups (P＞0.05).On the 5th and 10th day after surgery, the positive rate of bacterial culture in the experimental group was significantly lower than that in the control group at corresponding time points, with statistical significance (P＜0.05).The incidence of adverse reactions in the experimental group was 100% (27/27), which was significantly lower than 27.6% (8/29) in the control group, and the difference was statistically significant (P＜0.05).

Conclusion

Low-temperature plasma radiofrequency ablation can reduce postoperative hospital stay, improve the grade of incision healing,reduce postoperative complications, and improve the bacterial culture results of postoperative wounds, and can be used as an option for infection mesh removal.