合并肝硬化腹腔积液的腹股沟疝治疗进展

Treatment of inguinal hernia with liver cirrhosis accompanied by ascites

腹腔积液是肝功能失代偿期的表现,合并肝硬化腹腔积液的病人,腹股沟疝发病率增高。腹腔积液、低蛋白血症、凝血功能障碍、血小板减少、贫血、白细胞减少以及肝性脑病、肝肾综合征使此类病人的治疗充满挑战。现有指南并未对这一特殊人群的治疗做出明确的指导,针对肝硬化腹腔积液病人的腹股沟疝修补的最佳时机和手术方法尚存争议。越来越多的研究证据表明,采用个体化原则,多学科协作可使此类病人获益。

Ascites is a feature of decompensated liver cirrhosis. The prevalence of inguinal hernia increases in cirrhotic patients with ascites. Ascites,hypoproteinemia,coagulopathy,thrombocytopenia,anemia,leucopenia,as well as hepatic encephalopathy and hepatorenal syndrome can make the management of these patients challenging. The guidelines do not provide specific treatment for them. The optimal surgical treatment as well as timing of inguinal hernia repair in this situation remains controversial. More researches suggest that individualization of treatment options combined with multidisciplinary team can benefit this particular population.