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成人腹股沟嵌顿疝:临床表现与治疗结果

Incarcerated groin hernias in adults: presentation and outcome.

作者信息

Alvarez J A, Baldonedo R F, Bear I G, Solís J A S, Alvarez P, Jorge J I

机构信息

Service of General Surgery, Hospital San Agustín, Avilés, Spain.

出版信息

Hernia. 2004 May;8(2):121-6. doi: 10.1007/s10029-003-0186-1. Epub 2003 Nov 19.

Abstract

Despite universal acceptance of the value of elective hernia repair, many patients present with incarceration or strangulation, which are associated with significant morbidity and mortality. We reviewed 147 patients who underwent emergency surgery for incarcerated groin hernias during a 10-year period in order to analyze the presentation and outcome in our practice. Median age of the patients was 70 years. There were 77 men and 70 women. Femoral hernias were seen in 77 patients and inguinal hernias in 70. Coexisting diseases were found in 82 cases (55.8%). Bowel resection was required in 19 patients (12.9%). The overall and major morbidity rates were 41.5% and 9.6%, respectively. The mortality rate was 3.4%. Longer duration of symptoms, late hospitalization, concomitant diseases, and high ASA class were found to be significant factors linked with unfavorable outcomes. Because of high morbidity and mortality associated with incarceration, elective repair of groin hernias should be done whenever possible.

摘要

尽管选择性疝修补术的价值已得到普遍认可,但仍有许多患者出现嵌顿或绞窄,这与显著的发病率和死亡率相关。我们回顾了147例在10年期间接受腹股沟嵌顿疝急诊手术的患者,以分析我们实际工作中的临床表现和治疗结果。患者的中位年龄为70岁。其中男性77例,女性70例。77例患者为股疝,70例为腹股沟疝。82例(55.8%)患者存在合并疾病。19例(12.9%)患者需要进行肠切除。总体发病率和主要发病率分别为41.5%和9.6%。死亡率为3.4%。症状持续时间较长、住院较晚、合并疾病以及美国麻醉医师协会(ASA)分级较高被发现是与不良预后相关的重要因素。由于嵌顿相关的高发病率和死亡率,应尽可能进行腹股沟疝的选择性修补。

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