摘要
目的分析择期闭孔疝的临床特征并探讨其治疗方法。方法回顾性分析2013年8月至2018年8月,四川大学华西医院收治的11例择期行无张力闭孔疝修补患者的临床资料。分析其临床特征,探讨手术治疗方法,记录术后并发症发生及复发情况。结果11例患者均为女性,确诊为闭孔疝,病程2个月至14年,平均体质量指数(17.62±2.16)kg/m2,平均年龄(76.63±9.15)岁,合并心肺疾病4例。均有反复下腹痛。术前诊断为双侧闭孔疝4例;术前诊断为单侧闭孔疝,术中探查后证实为双侧闭孔疝6例;1例术前及术中证实为单侧,仅行右侧闭孔疝无张力修补,半年后出现新发左侧闭孔疝。所有患者术后随访无闭孔疝复发,无再腹痛,无肠梗阻及腹股沟区慢性疼痛,无大腿及膝部放射性疼痛。所有患者术后切口均无感染。结论择期闭孔疝常见于高龄消瘦女性,病程长,往往并发心肺基础疾病,临床表现反复下腹疼痛,通常不伴肠梗阻,腹部CT对诊断有重要价值。临床上误诊率高,通常是双侧并发,采用无张力修补复发率低,并发症少,可供借鉴。
Objective To analyze the clinical features of elective obturator hernia and to explore its treatment.Methods A retrospective analysis of 11 patients undergoing elective tension free obturator hernia repair from August 2013 to August 2018 in West China Hospital of Sichuan University was conducted to analyze the clinical features,to explore surgical treatment methods,and to record the postoperative complications and recurrence.Results All the 11 patients were diagnosed as obturator hernia and later confirmed intraoperatively.The course of the disease ranged from 2 months to 14 years.The mean age was(76.63±9.15)years,the average BMI was(17.62±2.16)kg/m2,and 4 cases were accompanied with cardiopulmonary comorbidities.Recurrent lower abdominal pain was found in all cases.The preoperative diagnosis of 4 cases of bilateral and 7 cases of unilateral obturator hernia were made.However,during intraoperative exploration,6 among 7 cases of preoperatively diagnosed unilateral obturator hernia were found to be bilateral.And remaining one case of unilateral obturator hernia also developed new-onset obturator hernia at contralateral side after 6 months of surgery.And no cases of hernia recurrence,postoperative abdominal pain,pain radiation to thigh,intestinal obstruction,chronic pain at inguinal region and wound infection were found.Conclusion Elective obturator hernia is common in elderly women with low weight,often with cardiopulmonary diseases,clinical manifestations of repeated lower abdominal pain,usually without intestinal obstruction,abdominal CT has a certain value for diagnosis.The clinical misdiagnosis rate is high,usually bilateral.Tension free repair has low recurrence rate and less complications,and can be used for reference.
作者
彭雪峰
雷文章
Peng Xuefeng;Lei Wenzhang(Department of Gastroenterology,West China Hospital,Sichuan University,Chengdu 610000,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2020年第3期277-279,共3页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
关键词
闭口疝
疝修补术
择期
Obturator hernia
Herniorrhaphy
Elective
