Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, China.
Postgraduate College, Liaoning University of Traditional Chinese Medicine, Shenyang, China.
J Evid Based Med. 2016 Nov;9(4):170-180. doi: 10.1111/jebm.12225.
Umbilical hernia is a common abdominal complication in cirrhotic patients with ascites. Our study aimed to evaluate the correlation of umbilical hernia with the volume of ascites.
Cirrhotic patients that underwent axial abdominopelvic computed tomography (CT) scans at our hospital between June 2012 and June 2014 were eligible. All CT images were reviewed to confirm the presence of umbilical hernia. The volume of ascites was estimated by five-point method.
One hundred and fifty-seven patients were enrolled into this study. Among them, 101 patients had ascites and 6 patients had umbilical hernia. Alkaline phosphatase (AKP) and serum sodium were significantly lower in patients with umbilical hernia (P = 0.008, P = 0.011, respectively). Child-Pugh scores and the volume of ascites were significantly higher in patients with umbilical hernia (P = 0.03, P < 0.0001, respectively). Correlation analysis demonstrated that the volume of ascites, Child-Pugh scores, and blood ammonia had positive correlations with umbilical hernia (r = 0.4579, P < 0.0001; r = 0.175, P = 0.03; r = 0.342, P = 0.001, respectively) and that serum sodium had a negative correlation with umbilical hernia (r = -0.203, P = 0.011). In patients with ascites ≥2000 mL, only AKP was significantly associated with umbilical hernia (P = 0.0497). No variables were significantly associated with umbilical hernia in a subgroup analysis of patients matched according to the volume of ascites.
The volume of ascites has a positive correlation with umbilical hernia. However, the factors associated with umbilical hernia in patients with severe ascites remain unclear.
脐疝是肝硬化腹水患者常见的腹部并发症。本研究旨在评估脐疝与腹水容量的相关性。
我们对 2012 年 6 月至 2014 年 6 月在我院行轴位腹盆部 CT 扫描的肝硬化患者进行了筛选。所有 CT 图像均经审查以确认脐疝的存在。腹水容量采用五点法进行评估。
本研究共纳入 157 例患者。其中 101 例有腹水，6 例有脐疝。脐疝患者的碱性磷酸酶（AKP）和血清钠明显较低（P=0.008，P=0.011）。Child-Pugh 评分和腹水容量在脐疝患者中明显较高（P=0.03，P<0.0001）。相关性分析表明，腹水容量、Child-Pugh 评分和血氨与脐疝呈正相关（r=0.4579，P<0.0001；r=0.175，P=0.03；r=0.342，P=0.001），血清钠与脐疝呈负相关（r=-0.203，P=0.011）。在腹水≥2000mL 的患者中，仅 AKP 与脐疝显著相关（P=0.0497）。在按腹水容量匹配的亚组分析中，没有变量与脐疝显著相关。
腹水容量与脐疝呈正相关。然而，严重腹水患者与脐疝相关的因素仍不清楚。
