Abdominal wall Hernia Complicating Continuous Ambulatory Peritoneal Dialysis

連續性可動式腹膜透析併發腹壁疝氣

陳漢文(Hon-Man Chan) ； 謝建勳(Jan-Sing Hsieh) ； 黃哲人(Che-Jen Huang) ； 黃裕勝(Yu-Sheng Huang) ； 黃宗人(Tsung-Jen Huang) ； 蔡秋月(Chiu-Yueh Tsai) ； 陳鴻鈞(Hung-Chun Chen)

《The Kaohsiung Journal of Medical Sciences》 10卷8期 (1994/08) Pp. 444-448

https://doi.org/10.6452/KJMS.199408.0444

摘要

以連續性可動式腹膜透析術治療連毒症病人愈來愈普遍，晊這些病人常有腹壁疝氣。它的發生原因有(1)病人腹壁在解剖上有缺損或組織薄弱及(2)腹膜透析液造對的腹內壓增加。自1987年至1991年5年中有八位連毒病人接受連續性可動式腹膜透析後發生疝氣，佔同期間接受這項治療的病人18.18%。包括5位腹股溝疝氣，2位割口疝氣及1位臍疝氣，其中接受手術治療的5位腹股溝疝氣病人，其術後良好並能繼續腹膜透析治療。另一名因嵌塞性割口疝氣合併腸壞死，在術後因敗血症死亡。我們的報告顯示：(1)接受連續性可動式腹膜透析術治療前應詳細檢查是否有存在性的腹壁疝氣。(2)如腹壁疝氣併有症狀應考慮接受手術治療。(3)對這種疾病的認識可減少嚴重的併發症。

並列摘要

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 theses hernias: anatomically weak sites and increased intraperitoneal pressure by the dialysate. Abdominal wall her-nia 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 in-cisional). Ater surgery, 5 patients returned to CAPD without recurrence and the remain-ing one died of strangulated incisional hernia. Our series shows that: (1) a detailed ex-amination of the preexisting hernia and repair prior to CAPD treatment are suggested. (2) symptomatic abdominal wall hernia should be evaluated carefully and treated pro-mptly. (3) awareness of the complication of theses hernias can reduce the morbidity and mortality.

並列關鍵字

CAPD ； hernia