摘要
目的探讨局麻下无张力疝修补术治疗腹股沟疝伴肝硬化患者的疗效,总结应用经验。方法回顾性分析2007年1月-2015年12月在首都医科大学附属北京佑安医院行局麻下无张力疝修补的167例腹股沟疝伴肝硬化病例的临床资料。根据ChildPugh分级标准,将所有病例分为Child-Pugh A/B级组和C级组,计量资料2组间比较采用t检验;计数资料2组间比较采用χ~2检验及Fisher确切概率法检验。结果所有局麻下无张力疝修补手术均顺利完成,平均手术时间为(55.22±21.67)min,术后平均住院时间为(3.14±1.86)d,术后有25例(14.97%)患者共计出现47种并发症。2组的平均术后住院时间[(2.72±1.25)d vs(4.43±3.11)d]以及术后并发症发生率(8.78%vs 63.10%)比较差异均有统计学意义(t=1.984,χ~2=2.861,P值均<0.05)。在C级组中,术前肝功能未改善者的术后并发生症发生率与改善病例差异无统计学意义(100%vs 86.7%,P>0.05),但术后住院时间差异统计学意义(6.85 d vs 3.80 d,P<0.05)。结论局麻下无张力疝修补术是一种简便易行、安全有效的治疗肝硬化并发腹股沟疝的方法,围手术期的肝功能评估与维护是保证手术实施和术后顺利恢复的重要条件。
Objective To investigate the clinical effect of tension - free hernia repair under local anesthesia in patients with liver cirrhosis complicated by inguinal hernia and related application experience. Methods A retrospective analysis was performed for the clinical data of 167 patients with liver cirrhosis complicated by inguinal hernia who underwent tension - free hernia repair under local anesthesia in our hospital from January 2007 to December 2015. The t - test was used for comparison of continuous data between two groups, and the chi - square test and Fisher＇ s exact test were used for comparison of categorical data between groups. Results All tension - free hernia repair surgeries were successfully completed, with a mean time of operation of （55.22 ± 21.67） min and a mean postoperative hospital stay of （3.14 ± 1.86） d. Of all patients, 25 （14.97%） experienced complications, and there were 47 complications in total. According to the Child - Pugh class, the patients were divided into Child -Pugh class A/B group and Child -Pugh class C group, and there were significant differences in the mean postoperative hospital stay （ （2.72 _＋ 1.25 ） d vs （4.43 _＋ 3.11 ） d, t = 1. 984, P 〈 0.05） and incidence rate of postoperative complications （ 8.78% vs 63. 1% , X2 = 2. 861, P 〈 0.05 ）. In the Child - Pugh class C group, there was no significant difference in the incidence rate of postoperative complications between the patients without improvement in liver function and those with improvement （ 100% vs 86.7% , P 〉 0.05） , but there was a significant difference in the length of postoperative hospital stay （6.85 d vs 3.80 d, P 〈 0. 05 ）. Conclusion Tension - free hernia repair under local anesthesia is a simple, safe, and effective method for the treatment of inguinal hernia complicated by liver cirrhosis. Perioperative liver function evaluation and maintenance is important to ensure the implementation of surgery and good postoperative recovery.
出处
《临床肝胆病杂志》
CAS
2017年第6期1116-1119,共4页
Journal of Clinical Hepatology
基金
北京市医院管理局重点医学专业发展计划(ZYLX201311)
关键词
疝
腹股沟
肝硬化
无张力疝修补
hernia, inguinal
liver cirrhosis
tension - free repair
