评估局部浸润联合神经阻滞麻醉下行开放Lichtenstein无张力疝修补术在腹膜透析相关腹股沟疝患者中的安全性与有效性。

回顾性分析2015年2月至2025年2月首都医科大学附属北京中医医院及其医联体单位（北京中医医院顺义医院、北京中医医院延庆医院）收治的63例腹膜透析相关腹股沟疝患者的临床资料。所有患者均在局部浸润联合神经阻滞麻醉下接受开放Lichtenstein无张力疝修补术。收集患者人口学特征、疝类型、手术相关指标、围手术期并发症及随访结局。采用描述性统计方法，连续变量以中位数（四分位数）[M（Q₁，Q₃）]表示，分类变量以例数（%）表示。

63例患者均顺利完成手术。患者年龄64（60，67）岁，腹膜透析龄33（17，50）个月。疝类型以腹股沟斜疝为主（87.3%），双侧疝占27.0%。手术时长50（45，58）min，术后住院时间1.5（1.0，2.0）d，术后24 h疼痛视觉模拟评分法评分2（1，2）分。围手术期按既定方案管理透析：术前短期停腹膜透析并过渡血液透析，术后7（7，7）d后分阶段恢复腹膜透析。围手术期未发生透析液渗漏或腹膜炎。术后30 d内轻微并发症发生率为6.3%，均经保守治疗缓解。在完成术后1年随访的60例患者中未观察到疝复发。

在腹膜透析相关腹股沟疝患者中，局部麻醉下开放Lichtenstein无张力疝修补术结合规范的围手术期透析管理总体安全可行，可实现低疼痛、短住院及良好的短中期随访结局，但仍需前瞻性对照研究进一步验证并优化透析管理策略。

To evaluate the safety and effectiveness of open Lichtenstein tension-free hernia repair under local infiltration combined with nerve block anesthesia in patients with peritoneal dialysis (PD)-related inguinal hernia.

Clinical data of 63 patients with peritoneal dialysis-related inguinal hernia who were treated between February 2015 and February 2025 at Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, and its affiliated centers (Yanqing Hospital of Beijing Chinese Medicine Hospital and Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital) were retrospectively analyzed. All patients underwent open Lichtenstein tension-free hernia repair under local infiltration combined with nerve block anesthesia. Demographic characteristics, hernia type, operative indicators, perioperative complications, and follow-up outcomes were collected. Using descriptive statistical methods, continuous variables are presented as median (Q₁,Q₃), and categorical variables as number (%).

All 63 patients successfully completed the procedure. The median age was 64 (60, 67) years, and the median duration of peritoneal dialysis was 33 (17, 50) months. Indirect inguinal hernia was the predominant type (87.3%), and bilateral hernias accounted for 27.0%. The median operative time was 50 (45, 58) minutes, and the median postoperative hospital stay was 1.5 (1.0, 2.0) days. The median Visual Analog Scale (VAS) pain score at 24 hours postoperatively was 2 (1, 2) points. Perioperative dialysis was managed according to a standardized protocol, including temporary cessation of peritoneal dialysis with transition to hemodialysis preoperatively and stepwise resumption of peritoneal dialysis postoperatively after a median of 7 (7,7) days. No dialysate leakage or peritonitis occurred during the perioperative period. Minor complications within 30 days occurred in 6.3% of patients and resolved with conservative management. In the 60 patients who completed the 1-year postoperative follow-up, no hernia recurrence was observed.

For patients with peritoneal dialysis-related inguinal hernia, open Lichtenstein tension-free repair under local anesthesia combined with standardized perioperative dialysis management appears to be safe and feasible. It can achieve low postoperative pain, short hospital stay, and favorable short- to mid-term outcomes. Prospective controlled studies are warranted to further validate these findings and optimize dialysis management strategies.