【摘要】 目的总结疝修补术在脐疝合并肝硬化腹水患者中的手术治疗经验,评估治疗效果。方法回顾性分析2009年7月至2016年2月,首都医科大学附属北京佑安医院行择期补片脐疝修补术的42例合并肝硬化腹水患者的临床资料,随访观察术后并发症及复发情况,评估手术效果。结果 42例脐疝修补手术均顺利完成,腹膜前修补35例,Onlay修补7例,脐环平均直径2.3 cm(1.5~5.0 cm),平均手术时间56 min(41~74 min),术后平均住院时间5.3 d(3~16 d)。术后伤口脂肪液化3例,伤口感染1例,给予清创换药后愈合;伤口周围淤血5例,保守治疗后自行吸收。定期随访0.5~4.0年,所有病例均无脐疝复发,无手术相关死亡。结论在围手术期有效控制腹水的基础上,合并肝硬化腹水患者应用补片的择期脐疝修补术是一种安全、有效的手术方式。更多还原

【Abstract】 Objective To summarize the application of umbilical hernia mesh repair in cirrhotic patients with ascites,and to evaluate the effect of the surgical treatment. Methods From July 2009 to February 2016,a total of 42 cases of cirrhotic patients with ascites underwent umbilical hernia mesh repair.The clinical and follow-up datas were collected and analyzed,and the post-repair results including the complications and recurrence of umbilical hernia were assessed. Results All the elective umbilical hernia mesh repairs were successfully completed,including 35 cases of preperitoneal repair,7 cases of onlay repair. The average diameter of umbilical ring was 2. 3 cm( 1. 5 to 5. 0 cm),the average operation hour was56 minutes( 41 to 74 minutes),and the average postoperative hospital stay was 5. 3 day( 3 to 16 days).There were 3 cases of postoperative fat liquefactive complication,1 case of wound infection,and 5 cases of congestion around the wound,which were healed by debridement,redressing and conservative treatment,respectively. There were no umbilical hernia recurrence and no repair-related death. Conclusion On the basis of effective control of ascites,elective mesh repair is a safe and effective treatment of umbilical hernia for cirrhotic patients with ascites.更多还原