静脉曲张合并腹疝的并发手术治疗

A. Chernookov, M. R. Kuznetsov, S. Kandyba, A. Atayan, Yu. N. Lebedeva, A. A. Ramazanov
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摘要

目的:探讨静脉曲张合并前腹壁疝(腹疝)并发手术的可行性。患者与方法:报告82例腹疝合并下肢静脉曲张病患者的治疗结果。根据临床和器械检查资料确定手术方法选择和手术干预范围。通常,利希滕斯坦无张力疝修补联合横切面切除术、血管内激光凝固(EVLC)、静脉曲张射频消融(VVRFA)。在采用并行手术后1-2年分析远期结果。术前及术后1年的生活质量采用SF-36量表进行评定。结果:男性45例(54.9%),女性37例(45.1%),年龄19 ~ 69岁。在20例(24.4%)住院患者中,工作与身体活动有关,56例(68.3%)患者处于最能运动的年龄:19至50岁。入院时,78名患者有抱怨。通常,他们有合并静脉曲张疾病与腹股沟或脐疝。在采用并行手术后,在该患者队列中未观察到特异性并发症,以及两种疾病合并的并发症。长期来看,患者的总体健康状况改善了23.2%。术前身体功能指标41.27分;手术后,该指标根据患者的估计增加了1.6倍,达到67.32分。术后生命活动的积极趋势最大(42.8%),情绪状态导致的角色限制最大(57.3%)。同时进行手术的患者生活质量各项指标均提高18.2-53.9%。结论:所获得的结果证明了并发手术治疗静脉曲张病变合并腹疝的安全性和有效性。关键词:并发手术,静脉曲张病变,腹侧疝,生活质量,术后并发症。引用本文:Chernookov a.i., Kuznetsov m.r., Kandyba S.I.等。静脉曲张合并腹疝的并发手术治疗。俄罗斯医学调查。2022;6(4):164-170(俄文)。DOI: 10.32364 / 2587-6821-2022-6-4-164-1。
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Concurrent surgeries in patients with varicose vein disease and ventral hernias
Aim: to substantiate the feasibility of concurrent surgeries in patients with varicose vein disease and anterior abdominal wall hernias (ventral hernias). Patients and Methods: the paper presents the treatment results of 82 patients with ventrial hernias and lower limb varicose vein disease. The method choice and the scope of surgical intervention were determined on the basis of clinical and instrumental examination data. Commonly, Lichtenstein tension-free hernia repair in combination with crossectomy, endovasal laser coagulation (EVLC), varicose veins radiofrequency ablation (VVRFA) were performed. The long-term results were analyzed 1–2 years after the use of concurrent surgeries. The life quality before surgery and a year after was determined by the SF-36 questionnaire. Results: the patients consisted of 45 (54.9%) men and 37 (45.1%) women aged 19 to 69 years. In 20 (24.4%) of the admitted patients, work was associated with physical activity, and 56 (68.3%) patients were at the most capable age: 19 to 50 years. Upon admission to the clinic, 78 patients had complaints. Commonly, they had a combination of varicose vein disease with inguinal or umbilical hernias. After the use of concurrent surgeries, no specific complications were observed in this patient cohort, as well as complications associated with both diseases concomitantly. In the long-term period, patients noted an improvement in their general health by 23.2%. In the preoperative period, the indicator of physical functioning was 41.27 points; after the operation, there was an increase in this indicator according to patients’ estimates by 1.6 times — to 67.32 points. After surgery, the greatest positive trend of vital activity (42.8%) and role limitations due to emotional state (57.3%) were observed. There was an increase in all indicators of life quality by 18.2–53.9% in patients who underwent concurrent surgeries. Conclusion: the obtained results demonstrated the safety and high efficacy of concurrent surgeries in patients with varicose vein disease and ventral hernias. Thus, the use of concurrent surgeries is considered to be an alternative to the staged treatment of patients with varicose vein disease and ventral hernias KEYWORDS: concurrent surgeries, varicose vein disease, ventral hernias, life quality, postoperative complications. FOR CITATION: Chernookov A.I., Kuznetsov M.R., Kandyba S.I. et al. Concurrent surgeries in patients with varicose vein disease and ventral hernias. Russian Medical Inquiry. 2022;6(4):164–170 (in Russ.). DOI: 10.32364/2587-6821-2022-6-4-164-1.
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