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中华疝和腹壁外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (02) : 121 -124. doi: 10.3877/cma.j.issn.1674-392X.2023.02.001

综述

肝硬化腹水合并腹股沟疝的临床治疗进展
张晓贝1, 曹栋1, 杨宝顺1, 俞永江1,()   
  1. 1. 730000 兰州大学第一医院普外科
  • 收稿日期:2022-07-08 出版日期:2023-04-18
  • 通信作者: 俞永江
  • 基金资助:
    兰州大学第一医院院内基金(ldyyyn2021-105)

Progress in the clinical management of cirrhotic ascites combined with inguinal hernia

Xiaobei Zhang1, Dong Cao1, Baoshun Yang1, Yongjiang Yu1,()   

  1. 1. Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, China
  • Received:2022-07-08 Published:2023-04-18
  • Corresponding author: Yongjiang Yu
引用本文:

张晓贝, 曹栋, 杨宝顺, 俞永江. 肝硬化腹水合并腹股沟疝的临床治疗进展[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(02): 121-124.

Xiaobei Zhang, Dong Cao, Baoshun Yang, Yongjiang Yu. Progress in the clinical management of cirrhotic ascites combined with inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(02): 121-124.

对于合并肝硬化腹水的腹股沟疝患者,根据Child-Pugh分级,采取严格的围手术期处理,包括控制腹水、营养支持、保护肝功能、调整凝血功能、预防感染等,然后行择期无张力腹股沟疝修补术为安全有效的治疗方法,可以明显改善患者生活质量,其中,有效控制腹水是手术成功的关键。最佳的手术方式尚存在争议,但局部麻醉使得肝功能Child-Pugh分级C级不再是绝对手术禁忌,由于急诊手术的并发症和死亡率均明显升高,对于肝硬化合并腹水的腹股沟疝患者应该采取更加积极的手术治疗。

For patients with inguinal hernia with cirrhosis ascites, adopting strict perioperative treatment, including ascites control, nutritional support, protecting liver function, adjusting coagulation function, and preventing infection, etc., and then elective no tension inguinal hernia repair for safe and effective treatment, can significantly improve the quality of life of patients, among which, effective ascites control is the key to successful surgery. Child-Pugh grade C is no longer an absolute surgical contraindication because local anesthesia has rendered it no longer a surgical contraindication. Patients with inguinal hernia, cirrhosis, and ascites should have more aggressive surgical therapy due to the greatly increased risk of complications and mortality associated with emergency surgery.

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