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[绞窄性腹股沟疝在热带地区仍然常见]

[Strangulated groin hernia still frequent in tropical milieu].

作者信息

Lebeau R, Kassi F Brou Assamoi, Yénon S Kacou, DianéC B, Kouassi J-C

机构信息

Services de Chirurgie Viscérale et Digestive, C.H.U. de Bouaké, Abidjan.

出版信息

Rev Med Brux. 2011 May-Jun;32(3):133-8.

Abstract

This study aimed to describe the epidemiological, clinical, therapeutic and postoperative data of strangulated groin hernia. Details of consecutive adults patients admitted to our emergency wards for strangulated groins hernia and operated on from august 1998 to december 2007 were recorded. In addition the mode of presentation, hernia type, treatment and outcome were also recorded for each case. The statistical analysis used the Chi2 test and the Fischer test. 149 strangulated groin hernias were recorded in 135 men and 14 women. Inguinal hernias were seen in 143 patients and femoral hernia in 6. Median age was 40 years. The mean delay for consultation was 2 days. Richter hernia, Maydl hernia and hernia abscess were seen in eight, two and three cases each. Bowel resection was required in 30 patients. Inguinal hernia underwent Bassini's procedure, Shouldice procedure and Mac Vay's procedure. While femoral hernia underwent only Mac Vay's procedure. No hernia repair was undergone in hernia abscess. Mortality was 10%. Bowel necrosis, long duration of symptoms, ASA class, bowel resection and strangulated groin hernia with hernia abscess, peritonitis and occlusion were found to be significant factors linked with unfavorable outcome. Morbidity was 16.7% and required reoperation in 9 patients; sepsis and hematoma were the most frequent complication. In conclusion, strangulated groin hernia still remain a frequent matter of consultation in visceral ward in tropical milieu. The high morbidity and mortality rate are unacceptable because of the possibility of avoiding them by early consultation and elective repair of groin hernia.

摘要

本研究旨在描述绞窄性腹股沟疝的流行病学、临床、治疗及术后数据。记录了1998年8月至2007年12月期间因绞窄性腹股沟疝入住我院急诊病房并接受手术的连续成年患者的详细情况。此外,还记录了每例患者的临床表现方式、疝类型、治疗方法及结果。统计分析采用卡方检验和费舍尔检验。共记录了149例绞窄性腹股沟疝,其中男性135例,女性14例。143例为腹股沟疝,6例为股疝。中位年龄为40岁。平均就诊延迟时间为2天。分别有8例、2例和3例出现里脱疝、马德耳疝和疝脓肿。30例患者需要行肠切除。腹股沟疝采用巴西尼法、肖尔代斯法和麦克维法进行手术。而股疝仅采用麦克维法进行手术。疝脓肿未进行疝修补。死亡率为10%。发现肠坏死、症状持续时间长、美国麻醉医师协会分级、肠切除以及伴有疝脓肿、腹膜炎和肠梗阻的绞窄性腹股沟疝是与不良预后相关的重要因素。发病率为16.7%,9例患者需要再次手术;脓毒症和血肿是最常见的并发症。总之,在热带地区的内科病房,绞窄性腹股沟疝仍是常见的就诊原因。由于早期就诊和择期修补腹股沟疝有可能避免高发病率和死亡率,因此其高发病率和死亡率是不可接受的。

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