Lichtenstein术在基层医院腹膜透析并发腹股沟疝患者中的临床应用

Clinical application of Lichtenstein in peritoneal dialysis patients complicated with inguinal hernia in primary hospital

目的探讨基层医院腹膜透析并发腹股沟疝患者接受Lichtenstein术的临床效果。方法回顾性分析25例腹膜透析并发腹股沟疝患者的临床资料,25例患者并发腹股沟疝28例次,均接受Lichtenstein术式修补腹股沟疝治疗。观察并比较所有患者的手术及术后相关指标。结果所有患者单侧修补平均手术时间(52.82±8.35)min,术后24 h开始半量腹透,1周后恢复术前腹透方案,术后平均住院时间(5.41±1.14)d。25例患者中1例患者术后出现阴囊血清肿,予25%硫酸镁湿敷、红外线照射等对症治疗后好转,2例患者在后期透析过程中出现对侧腹股沟疝,均行Lichtenstein修补术。术后无腹股沟疝复发、切口感染、腹透液渗漏、腹腔感染等并发症发生。结论Lich⁃tenstein术用于腹膜透析并发腹股沟疝患者安全、有效,术后24 h即开始半量腹透,1周后恢复术前腹透方案,在临床实践中取得了令人满意的效果,值得基层医院临床推广应用。

Objective To investigate the clinical effect of Lichtenstein in peritoneal dialysis patients complicated with inguinal hernia.Methods The clinical data of 25 patients with peritoneal dialysis complicated with inguinal hernia were retrospectively analyzed,25 patients with inguinal hernia 28 times,all of whom received Lichtenstein operation to re⁃pair inguinal hernia.The operative and postoperative indexes of all patients were observed and compared.Results The mean operation time of unilateral repair was(52.82±8.35)minutes,half peritoneogram was started 24h after operation,and the preoperative peritoneogram was resumed 1 week later.The mean postoperative hospital stay was(5.41±1.14)days.Among the 25 patients,1 patient developed seroma of scrotum after surgery,which was improved after symptomatic treatment such as 25%magnesium sulfate wet compress and infrared irradiation,2 patients developed contralilar inguinal hernia during late dialysis,and Lichtenstein repairment was performed in both patients.There was no recurrent inguinal hernia,incisional infection,peritoneal fluid leakage,abdominal infection and other complications occurred after surgery.Conclusion Lichtenstein is safe and effective for patients with peritoneal dialysis complicated with inguinal hernia.Half peritoneal dialysis is started 24 hours after surgery,and the preoperative peritoneal dialysis program is resumed 1 week later,which has achieved satisfactory results in clinical practice and is worthy of clinical promotion and application in primary hospitals.