Функціональний стан м`язів черевної стінки при післяопераційних вентральних грижах: сучасні клінічні інструменти діагностики та прогнозу

2018 
Objective. Complex estimation of functional state of the abdominal wall muscles in postoperative abdominal hernias, using functional tests and interferential electromyography. Material and methods. The investigation was performed on the base of the Clinic in Cathedra of Surgery № 1 with Postgraduate Education of Odessa National Medical University. In 2003 - 2016 yrs 280 patients, suffering postoperative abdominal hernias (POAH), aged from 30 tо 75 yrs, were examined and operated. To Group I (comparison) were included 140 patients, to whom alloplasty in accordance to «onlay» method was performed. To Group II (the main) 140 patients were included, operated in accordance to original method of alloplasty with transposition of rectal muscles. The rate of recurrence, presence of the chronic abdominal pain syndrome, the abdominal press function were estimated in late postoperative period. All the patients were examined by neurologist and therapeutist. The data obtained in the investigation were processed in accordance to the dispersion analysis method, using the package of additional programs Statistica 10.0 (StatSoft Inc., USA). Results. In the patients of the main group at the end of the first follow-up year it became possible to improve the results of functional tests significantly: the abdominal press strength have constituted (7.3 ± 0.2) points, while in a control group – (4.0 ± 0.2) points. Аnalysis of the amplitude-frequency characteristic of electromyogram (ЕМG) have shown, than in 6 mo postoperatively in the main group the value of maximal amplitude have constituted (1195.5 ± 55.1) mcW, аnd frequency – (121.2 ± 6.7) Hz, while in a control group maximal amplitude was (788,8 ± 89,2) mcW, аnd frequency – (111.5 ± 9.9) Hz. Conclusion. Application of functional tests with conduction of interferential electromyography permits to estimate functional state of abdominal rectal muscles and clinical effect of the operative treatment performance in patients POAH.
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