疝与腹壁外科疾病治疗方案日趋多样化，加之高质量临床证据缺失、医患认知与偏好存在冲突，形成大量临床决策 “灰色地带”，传统决策模式已难以适配临床需求。医患共同决策（SDM）作为以患者为中心的决策模式，为解决这一困境提供了有效路径。本文阐述疝病治疗决策的复杂性，梳理SDM的理论基础与SHARE实施框架，总结其在疝病治疗中的国际循证实践与应用效果，同时分析我国SDM在疝与腹壁外科临床落地面临的政策支持不足、医护人员培训缺失、本土化决策辅助工具缺乏等挑战，并提出针对性应对策略。

The treatment options for hernia have been becoming increasingly diverse. Coupled with the lack of high-quality clinical evidence and conflicts between the cognition and preferences of doctors and patients, a large number of “grey areas” in clinical decision-making have emerged. The traditional decision-making model is no longer suitable for clinical needs. Shared decision-making (SDM), a patient-centered decision-making model, provides an effective solution to this predicament. This article elaborates on the complexity of decision-making in hernia treatment, reviews the theoretical basis and SHARE implementation framework of SDM, summarizes its international evidence-based practices and application effects in hernia treatment, and at the same time analyzes the challenges faced by the implementation of SDM in the clinical practice of hernia and abdominal wall surgery in China, such as insufficient policy support, lack of training for medical staff, and the absence of localized decision-making support tools. It also proposes targeted coping strategies.