人工材料在肝硬化肝功能失代偿脐疝的临床应用

Mesh repair for umbilical hernia in patients with hepatic cirrhosis decompensation

目的：探讨择期人工材料修补术在治疗肝硬化肝功能失代偿脐疝患者中的临床应用价值。方法回顾性分析2007年7月至2013年2月，漯河市中心医院在行人工材料修补术治疗肝硬化失代偿的9例脐疝患者临床资料，随访观察术后并发症及复发情况，观察手术疗效。结果9例患者手术均获得成功，手术时间50∽90 min，平均70 min。切口红肿2例，无渗血渗液，给予伤口换药加酒精纱布湿敷后好转，无切口感染。随访6∽24个月，失访1例，2例患者诉腹壁异物感，未做处理，5个月后症状自行缓解。随访期间患者无切口慢性疼痛及异物感，未见补片排斥、感染、复发等并发症，全组随访疗效满意，总体生活质量明显提高。结论肝硬化肝功能失代偿患者经过严格围手术期处理，能顺利接受人工材料疝修补术，人工材料修补术是治疗肝硬化肝功能失代偿患者的一种有效而可靠地术式，具有手术操作安全，并发症少，复发率低的特点。

Objective To discuss the clinical application value of selective tension-free herniorrhaphy for umbilical hernia in paitents with live cirrhosis decompensation.Methods Between July 2007 and February 201 3,the clinical data of nine cases of patients with umbilical hernia concomitant with cirrhosis in Luohe Central Hospital were analyzed retrospectively,and the operative effect,postoperative complications and recurrence were observed.Results All of the operations was successful,and the operating time was 50 to 90 minutes,an average of 70 minutes.2 cases of incision swelling occurred without bleeding or oozing,both of them were cured after alcohol wet dressing without wound infection.The patients were followed up for 6 to 24 months excepted for one loss of follow-up.2 patients complained of abdominal foreign body sensation,which relieved after 5 months without further treatment.During the follow-up period,neither incision chronic pain and discomfort,nor mesh rejection,infection or recurrence were observed.The efficacy of all patients followed up was satisfactory with the quality of life improved significantly.Conclusions After rigorous perioperative management,the patients can be performed successfully with tension-free herniorrhaphy,which is a reliable and effective operation to patients with live cirrhosis decompensation,and it also has advantages of less complications and lower recurrence rate.