探讨在肝硬化腹水合并脐疝患者的外科治疗中Onlay术式和腹膜前疝修补术式治疗效果的差异。

回顾性分析2010年1月至2018年1月，上海交通大学医学院附属第一人民医院收治的肝硬化腹水合并脐疝25例患者的临床资料。根据术式不同分为2组，对照组患者13例行Onlay术式，试验组患者12例行腹膜前疝修补术。比较2组手术时间、排气时间、住院时间、伤口愈合情况及术后复发等观察指标，并进行统计学分析。

对照组平均手术时间（56.9±16.3）min，住院时间（8.7±5.8）d，排气时间（2.6±0.7）d。试验组平均手术时间（49.4±17.1）min，住院时间（10.8±4.7）d，排气时间（2.7±0.6）d。2组术后疼痛评分、伤口愈合情况等比较，差异均无统计学意义（P>0.05）。观察期内对照组出现轻微伤口感染患者1例，2组患者均未出现复发情况。

对于肝硬化腹水合并脐疝患者，Onlay和腹膜前疝修补两种术式在治疗效果可能无明显差异。

To investigate the difference between onlay and sublay repair in surgical treatment of umbilical hernia complicated with cirrhotic ascites.

The data of patients with umbilical hernia complicated with hepatocirrhosis ascites in Beijing Chao-Yang Hospital from January 2010 to January 2018 were retrospectively analyzed. 25 cases were selected according to the criteria of inclusion and exclusion. According to onlay and sublay operation, they were divided into two groups: control group and experimental group. The preoperative ascites depth, operation time, exhaust time, hospital stay, postoperative wound healing and recurrence were observed and compared statistically.

In the control group, the average length of operation was (56.9±16.3) minutes, the hospitalization time was (8.7±5.8) days, and the exhaust time was (2.6±0.7) days. In the experimental group, the average length of operation was (49.4±17.1) minutes, the hospitalization time was (10.8±4.7) days, and the exhaust time was (2.7±0.6) days. There was no significant difference in postoperative pain score and wound healing between the two groups, and only 1 case in the control group had mild wound infection, and all the patients had no recurrence, and good therapeutic effect was obtained during the observation period.

Both onlay and sublay repair are safe and effective for patients with umbilical hernia complicated with cirrhosis ascites.