Misra D, Hewitt G, Potts S R, Brown S, Boston V E
Royal Belfast Hospital for Sick Children, Ireland.
J Pediatr Surg. 1994 Nov;29(11):1496-8. doi: 10.1016/0022-3468(94)90154-6.
Over a period of 6 years, 251 infants under 6 months of age underwent repair of inguinal hernias (IH; n = 311). There were 241 males and 10 females. Incarceration occurred in 59 infants (24%), one of whom had bilateral incarceration. As a result of the authors' policy to operate on infantile IH within 7 days of diagnosis, only 6% of the incarcerations occurred in already diagnosed cases. Sedation and taxis did not reduce the hernia in 22 cases (38%); transperitoneal closure of the internal ring was performed in 14 of these. Eighty-nine infants (36%) were born premature; thirty-nine (41%) of these had been ventilated before, a possible cause of the hernia. Bilateral presentation was more common in the premature infants (35% v 17%); surprisingly, incarceration was less common (13% v 24%). Hence, the policy of delaying herniotomy until discharge from the neonatal unit was justified. During follow-up, six recurrences were noted and two cases of testicular atrophy.
在6年的时间里，251名6个月以下的婴儿接受了腹股沟疝修补术（IH；n = 311）。其中男性241例，女性10例。59名婴儿（24%）发生了嵌顿，其中1例为双侧嵌顿。由于作者采取在诊断后7天内对婴儿腹股沟疝进行手术的策略，只有6%的嵌顿发生在已确诊的病例中。22例（38%）病例中，镇静和手法复位未能使疝回纳；其中14例进行了内环经腹关闭术。89名婴儿（36%）为早产儿；其中39名（41%）曾接受过机械通气，这可能是疝形成的一个原因。双侧疝在早产儿中更为常见（35%对17%）；令人惊讶的是，嵌顿较少见（13%对24%）。因此，将疝修补术推迟至新生儿病房出院后进行的策略是合理的。在随访期间，发现6例复发和2例睾丸萎缩。
