摘要
目的探讨日间手术模式下肝硬化腹水患者进行腹股沟疝修补术的可行性。方法回顾性分析空军军医大学第一附属医院(西京医院)2015年12月—2023年3月收治的日间手术模式下合并肝硬化腹水的择期腹股沟疝修补术患者的临床资料,对患者的诊疗情况和术后情况进行分析总结。结果最终纳入8例日间手术模式下合并肝硬化腹水的择期腹股沟疝修补术患者。部分患者为双侧疝,共有11例疝,均为斜疝,其中1例为复发疝。10例疝的手术方式为Lichtenstein手术,1例为腹腔镜经腹腹膜前疝修补术。8例患者围手术期均未使用抗菌药物。仅1例腹股沟复发疝术后复发,1例患者因腹水问题于肝病专科住院治疗后好转,无患者出现严重并发症和手术相关死亡。结论在有效改善肝硬化并发症的前提下,经过严格筛选的病情稳定的肝硬化腹水患者可以采用日间手术模式下的腹股沟疝修补术,但未来还需大样本量研究进一步阐明其具体应用条件和抗菌药物应用指征。
Objective To explore the feasibility of inguinal hernia repair in patients with cirrhotic ascites under day surgical mode.Methods The clinical data of patients undergoing elective inguinal hernia repair with concurrent cirrhotic ascites under the day surgical mode admitted to Xijing Hospital,the First Affiliated Hospital of the Air Force Military Medical University between December 2015 and March 2023 were retrospectively analyzed.The diagnosis,treatment,and postoperative conditions of the patients were analyzed and summarized.Results Ultimately,8 patients undergoing elective inguinal hernia repair with concurrent cirrhotic ascites under day surgical mode were included.Some patients had bilateral hernias,with a total of 11 cases of hernias.All of these hernias were oblique hernias,including 1 case of recurrent hernia.The surgical methods for 10 cases of hernia were Lichtenstein surgery,and 1 case used laparoscopic retroperitoneal hernia repair.All 8 patients did not use antibiotics during the perioperative period.Only 1 case of recurrent inguinal hernia occurred after surgery.Another patient was admitted to liver disease specialist ward due to ascites,and later improved.No patients experienced serious complication or surgery related death.Conclusions Under the premise of effectively improving complications of cirrhosis,patients with stable cirrhotic ascites who have undergone strict screening can undergo inguinal hernia repair surgery under the day surgical mode.However,further large-scale studies are needed in the future to clarify their specific application conditions and indications for the use of antibiotic.
作者
宁鹏涛
王权
高博欣
田小合
刘小南
NING Pengtao;WANG Quan;GAO Boxin;TIAN Xiaohe;LIU Xiaonan(Day Surgery Center,Xijing Hospital,the First Affiliated Hospital of the Air Force Military Medical University,Xi’an,Shaanxi 710032,P.R.China)
出处
《华西医学》
2025年第2期188-193,共6页
West China Medical Journal
基金
陕西省创新能力支撑计划(2022KRM184)。
关键词
腹股沟疝
肝硬化
腹水
日间手术
Inguinal hernia
cirrhosis
ascites
day surgery
