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[老年腹股沟疝]

[Inguinal hernia in old age].

作者信息

Broll R, Weisser C, Mühlschlegel M

出版信息

Dtsch Med Wochenschr. 1987 Apr 17;112(16):641-3. doi: 10.1055/s-2008-1068112.

Abstract

By retrospective analysis of the medical records from 1978-1985, the rates of incarceration, postoperative complications and lethality were determined with particular consideration of elective and emergency operations. The proportion of over 60 year old patients with inguinal hernia was 37.3%. The rate of incarceration in these patients (9.8%) was more than five times as high as in patients under 60 years old (1.8%); with increasing age, it rose from 3% to 36%. The Bassini technique predominated in the surgical treatment of the hernia. The rate of postoperative complications was 7.5%, wound infections (3.35%) and hematomas (3.07%) being the most frequent. Four patients died postoperatively, mostly of pulmonary complications; this corresponds to a lethality of 1.1% as compared to this corresponds to a lethality of 1.1% as compared to 0% in patients under 60 years old. Emergency operations in incarcerated hernia display a lethality (5.71%) which is more than nine times as high as in elective operations (0.62%). The indication for surgery is hence to be established rather extensively in the elderly, since the danger of incarceration rises.

摘要

通过回顾分析1978年至1985年的病历,确定了监禁率、术后并发症发生率和死亡率,并特别考虑了择期手术和急诊手术。60岁以上腹股沟疝患者的比例为37.3%。这些患者的监禁率(9.8%)比60岁以下患者(1.8%)高出五倍多;随着年龄的增长,监禁率从3%上升到36%。疝的手术治疗以巴西尼技术为主。术后并发症发生率为7.5%,伤口感染(3.35%)和血肿(3.07%)最为常见。4例患者术后死亡,主要死于肺部并发症;与60岁以下患者0%的死亡率相比,这相当于1.1%的死亡率。嵌顿疝急诊手术的死亡率(5.71%)比择期手术(0.62%)高出九倍多。因此,由于监禁风险增加,在老年人中手术指征应更广泛地确立。

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