肝硬化顽固性腹腔积液患者合并腹股沟疝的外科治疗

目的探讨肝硬化顽固性腹腔积液患者合并腹股沟疝的外科治疗方法。方法对2002年5月～2005年5月收治的7例肝硬化顽固性腹腔积液合并腹股沟疝的病例,应用腹膜透析管腹腔置管围手术期控制腹腔积液,普理灵疝装置修补疝气,并随访观察其疗效。结果所有病例围手术期腹腔积液均得以有效控制,手术全部顺利完成,平均手术时间65min,术后1例并发阴囊血肿,切口渗血1例,腹腔积液渗漏1例。3例均经对症处理后缓解。随访1～36个月,1例因肝硬化、门脉高压合并上消化道出血、肝功能衰竭于术后45个月死亡;所有病例修补后无1例复发。结论腹膜透析管腹腔置管可有效控制肝硬化合并腹股沟疝病例顽固性腹腔积液,普理灵疝装置可作为疝修补的一种选择。

Surgical Therapy of Inguinal Hernia in Cirrhotic Patient with Refractory Ascites

Objective To investigate the Surgical therapy of inguinal hernia in cirrhotic patients with refractory ascites.Methods All of 7 cases with inguinal hernia in cirrhotic patients with refractory ascites from May.2002 to May.2005 were collected.Herniorrhaphy with Prolene Hernia System were adopted with temporary peritoneal dialysis catheter placement to control ascites,then patients were followed up and the them- peutical resultson was observed.Results Had successful repair of their hernia in all patients with no recurrence has been achieved for 1 to 36 months after operation,and 45 months later one died of liver function failure and upper digestive tract hemorrhage.Average operative time is 65 min.One of them occurred ascites leakage,one scrotum hematoma,one incision ooging of blood,all relaxed by oxpectant manage- ment.Conclusion Patients were able to effectively control ascites using the concomitant peritoneal dialysis catheter placement at hospitals and these cases report demonstrates that the method of Prolene Mesh Hernia System repair may be appropriate for groin hernias.