Chan H M, Hsieh J S, Huang C J, Huang Y S, Huang T J, Tsai C Y, Chen H C
Department of Surgery, Kaohsiung Medical College, Taiwan, Republic of China.
Gaoxiong Yi Xue Ke Xue Za Zhi. 1994 Aug;10(8):444-8.
Continuous ambulatory peritoneal dialysis (CAPD) is a well-established treatment modality for end-stage renal disease. Abdominal wall hernia is not uncommon in patients on CAPD. Two factors are responsible for the occurrence of these hernias: anatomically weak sites and increased intraperitoneal pressure by the dialysate. Abdominal wall hernia was reviewed in 44 patients on CAPD from 1987 through 1991. Eight abdominal hernias (5 inguinal, 2 incisional and 1 umbilical) were found during CAPD treatment (18.18%). Surgical treatment was applied in 6 symptomatic hernias (5 inguinal and 1 incisional). After surgery, 5 patients returned to CAPD without recurrence and the remaining one died of strangulated incisional hernia. Our series shows that: (1) a detailed examination of the preexisting hernia and repair prior to CAPD treatment are suggested. (2) symptomatic abdominal wall hernia should be evaluated carefully and treated promptly. (3) awareness of the complication of these hernias can reduce the morbidity and mortality.
持续性非卧床腹膜透析（CAPD）是终末期肾病一种成熟的治疗方式。腹壁疝在接受CAPD治疗的患者中并不少见。这些疝的发生有两个因素：解剖学上的薄弱部位以及透析液导致的腹腔内压力增加。回顾了1987年至1991年间44例接受CAPD治疗患者的腹壁疝情况。在CAPD治疗期间发现了8例腹疝（5例腹股沟疝、2例切口疝和1例脐疝）（18.18%）。6例有症状的疝（5例腹股沟疝和1例切口疝）接受了手术治疗。术后，5例患者恢复CAPD治疗且无复发，其余1例死于绞窄性切口疝。我们的系列研究表明：（1）建议在CAPD治疗前对原有疝进行详细检查并修复。（2）对有症状的腹壁疝应仔细评估并及时治疗。（3）认识到这些疝的并发症可降低发病率和死亡率。
