持续性非卧床腹膜透析病人并发腹股沟疝的外科治疗
Surgical treatment for inguinal hernia in continuous ambulatory peritoneal dialysis patients
Received date: 2021-08-02
Online published: 2022-07-22
目的:探讨安全有效地治疗持续性非卧床腹膜透析病人并发腹股沟疝的外科治疗方案。方法:回顾性分析2013年至2019年我院收治41例病人43侧腹股沟疝的临床资料、诊疗经过和随访结果。结果:同期收治的792例腹膜透析病人中,腹股沟疝的发病率为5.2%(41/792),平均年龄(62.1±10.7)岁,体质量指数 (21.6±4.9) kg/m2。原发疾病中慢性肾小球肾炎23例(56.1%),糖尿病肾病10例(24.4%),高血压性肾硬化4例 (9.7%)。确诊前透析时间(17.3±14.9)个月。单侧疝39例,双侧疝2例。中华医学会疝和腹壁外科学组腹股沟疝分型(2003版)Ⅰ型11侧,Ⅱ型30侧,Ⅲ型2侧。疝环直径(2.6±0.9) cm。41例均手术成功,41侧行轻型平补片无张力Lichtenstein手术,2侧行腹膜前UHS超普疝补片修补手术。平均手术时间 (46.7±17.3) min。手术并发症发生率19.5%,其中血清肿3例,阴囊水肿2例,切口出血、感染和慢性疼痛各1例。39例采用自动化腹膜透析14~33 d,2例采用临时中心静脉插管血液透析作为术后过渡性透析治疗。随访期(29.7±15.7)(2~65)个月,无疝复发。结论:轻型补片开放无张力Lichtenstein手术疗效明确,并发症轻微,为持续性非卧床腹膜透析病人并发腹股沟疝的首选术式。自动化腹膜透析为过渡性透析治疗的首选方式。
关键词: 持续性非卧床腹膜透析; 腹股沟疝; 疝修补术; 自动化腹膜透析
陈涛, 徐煜, 付学良, 袁志青, 花荣 . 持续性非卧床腹膜透析病人并发腹股沟疝的外科治疗[J]. 外科理论与实践, 2021 , 26(05) : 425 -429 . DOI: 10.16139/j.1007-9610.2021.05.013
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