Lichtenstein手术治疗肝硬化腹水合并腹股沟疝的临床疗效

Clinical efficacy of Lichtenstein surgery for cirrhosis ascites complicated with inguinal hernia

目的探讨Lichtenstein手术治疗肝硬化腹水合并疝环缺损直径<3.0 cm腹股沟疝的临床疗效。方法采用回顾性描述性研究方法。收集2010年1月至2018年1月中国医学科学院北京协和医院收治的50例行Lichtenstein手术治疗肝硬化腹水合并腹股沟疝患者的临床资料;男42例,女8例;平均年龄为66岁,年龄范围为45~73岁。观察指标:(1)手术及术后情况。(2)随访情况。采用门诊和电话方式进行随访,术后3、6个月随访1次,以后每6个月随访1次,随访时间为12~36个月,了解患者腹股沟疝复发情况及生存情况。随访时间截至2019年1月。正态分布的计量资料以Mean±SD表示;偏态分布的计量资料以M(范围)表示;计数资料以绝对数和(或)百分比表示。结果(1)手术及术后情况:50例患者均顺利完成手术,手术时间为(52±7)min,术后住院时间为(4.0±1.8)d。50例患者中,术后发生伤口脂肪液化1例,经换药处理后痊愈;发生阴囊水肿积液8例,经抽除积液治疗后痊愈;发生腹股沟区疼痛3例,经对症处理后缓解;发生尿潴留4例,经导尿膀胱锻炼后痊愈。(2)随访情况:50例患者中,完成随访48例,随访率为96%(48/50)。48例患者随访时间为12~36个月,中位随访时间为33个月。随访期间,腹股沟疝复发1例,因肝硬化相关并发症死亡2例。结论Lichtenstein手术治疗肝硬化腹水合并疝环缺损直径<3.0 cm腹股沟疝安全、可行。

Objective To investigate the clinical efficacy of Lichtenstein surgery for cirrhosis ascites complicated with inguinal hernia(hernia ring diameter<3.0 cm).Methods The retrospective and descriptive study was conducted.The clinicopathological data of 50 patients who underwent Lichtenstein surgery for cirrhosis ascites complicated with inguinal hernia in the Peking Union Medical College Hosptal of Chinese Academy of Medical Science between January 2010 and January 2018 were collected.There were 42 males and 8 females,aged from 45 to 73 years,with an average age of 66 years.Observation indicators:(1)surgical and postoperative situations;(2)follow up.Follow up was conducted through outpatient examination and telephone interview to detect the hernia recurrence and survival of patients at 3,6 months after operation and once every 6 months after 6 months up to January 2019.Measurement data with normal distribution were expressed as Mean±SD and measurement data with skewed distribution were expressed as M(range).Count data were expressed as absolute numbers and/or percentages.Results(1)Surgical and postoperative situations:50 patients underwent operation successfully.The operation time and duration of postoperative hospital stay were(52±7)minutes and(4.0±1.8)days.Among the 50 patients,1 case of postoperative wound fat liquefaction occurred and was healed after dressing change,8 cases of scrotal edema effusion occurred and were recovered after being treated with suction,3 cases of pain in groin area occurred and were relieved after symptomatic treatment,and 4 cases of urinary retention occurred and were cured after urethral catheterization and exercise of bladder.(2)Follow up:48 of the 50 patients were followed up,with a follow up rate of 96%(48/50).The 48 patients was followed up for 12-36 months with a median time of 33 months.During the follow up,1 case of inguinal hernia recurred and 2 cases died of complications related to cirrhosis.Conclusion Lichtenstein surgery is safe and feasible for the cirrhosis ascites complicated with inguinal hernia(hernia ring diameter<3 cm).