无张力疝修补术治疗腹股沟疝合并腹腔积液的临床疗效

Clinical effect of tension free hernia repair in the treatment of inguinal hernia combined with ascites

    摘要
  • 摘要: 目的:探讨无张力疝修补术治疗腹股沟疝合并腹腔积液的临床疗效。
    方法:采用回顾性横断面研究方法。收集2008年6月至2014年6月四川大学华西医院收治的81例腹股沟疝合并腹腔积液患者的临床资料。患者围术期限制钠及利尿治疗，严重低蛋白血症患者给予静脉输注Alb。患者均行无张力疝修补术，采用Gilbert手术方式。观察指标：(1)手术及术后情况：手术时间、疝环直径、疝缺损面积、术后血浆引流情况、术后引流管拔除时间、术后并发症情况、术后住院时间。(2)随访情况：腹股沟疝复发和远期并发症情况。采用电话、门诊或住院方式对患者进行为期24个月的随访，了解患者疝复发及远期并发症发生情况。随访时间截至2016年6月。正态分布的计量资料采用±s表示。
    结果:(1)手术及术后情况： 81例腹股沟疝合并腹腔积液患者均顺利完成无张力疝修补术，手术时间为(46±19)min，疝环直径为(3.1±0.7)cm，疝缺损面积为(25±13)cm2。81例患者中，65例术后放置血浆引流管，其中术后24 h 39例引流出淡血性液体≥100 mL，26例引流出淡血性液体<100 mL，65例患者术后引流管拔除时间为(3.2±1.0)d； 16例早期手术未放置血浆引流管。81例患者中，术后切口轻度血清肿9例，阴囊肿胀4例，均经充分引流后好转出院，术后住院时间为(6.7±1.7)d。(2)随访情况：81例患者中，76例获得完整随访，随访时间均为24个月，随访期间患者无腹股沟疝复发以及相关远期并发症发生。
    结论:无张力疝修补术治疗腹股沟疝合并腹腔积液安全可行，临床疗效较好。

     

    Abstract: Objective:To investigate the clinical effect of tensionfree hernia repair in the treatment of inguinal hernia combined with ascites.
    Methods:The retrospective crosssectional study was conducted. The clinical data of 81 inguinal hernia patients with ascites who were admitted to the West China Hospital of Sichuan University from June 2008 to June 2014 were collected. Patients with peritoneal effusion received restriction of sodium in take and diuretic therapy, and patients with severe hypoproteinemia received intravenous injection of albumin. All the patients underwent tensionfree hernia repair (Gilbert way). Observation indicators: (1) surgical and postoperative situations: operation time, diameter of hernia ring, defect area of hernia, postoperative plasma drainage, removal time of plasma drainagetube, postoperative complications and duration of hospital stay; (2) followup situation: recurrence and longterm complications of inguinal hernia. Followup using telephone interview, outpatient examination and inpatient examination was performed to detect the hernia recurrence and longterm complications for 24 months up to June 2016. Measurement data with normal distribution were represented as ±s.
    Results:(1) Surgical and postoperative situations: 81 inguinal hernia patients with ascites underwent successful tensionfree hernia repair. The operation time, diameter of hernia ring and defect area of hernia were respectively (46±19)minutes, (3.1±0.7)cm and (25±13)cm2. Sixtyfive patients received indwelling plasma drainagetube after repair, volume of light bloodstained fluid was respectively ≥100 mL in 39 patients and <100 mL in 26 patients at 24 hours postoperatively, with a removal time of plasma drainagetube of (3.2±1.0)days. Sixteen patients didn't receive indwelling plasma drainagetube. Of 81 patients, 9 and 4 were respectively complicated with mild seroma of incision and scrotal swelling, they were improved and then out of hospital after adequate drainage, with a duration of hospital stay (6.7±1.7)days. (2) Followup situation: of 81 patients, 76 were followed up for 24 months, without recurrence and related complications of inguinal hernia.
    Conclusion:The tensionfree hernia repair in the treatment of inguinal hernia combined with ascites is safe and feasible, with good clinical effects.

     

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