| 潘怡,贺茗梁,李佳仪,戚亚钦,朱康贝,张方捷.急性嵌顿性闭孔疝21例临床诊治经验及文献回顾[J].浙江中西医结合杂志,2026,36(3): |
| 急性嵌顿性闭孔疝21例临床诊治经验及文献回顾 |
| The experience in treating of acute incarcerated obturator hernia:21 cases and literature review |
| 投稿时间：2025-09-01 修订日期：2025-09-17 |
| DOI： |
| 中文关键词: 急性嵌顿疝 腹腔镜 闭孔疝 疝修补术 |
| 英文关键词:acute incarcerated hernia laparoscopy obturator hernia herniorrhaphy |
| 基金项目:2024浙江省中医药科技计划（2024ZL715）；装载人参外泌体的 PLGA-Collagen I 补片在大鼠腹壁切口疝模型的应用研究 |
|
| 摘要点击次数: 64 |
| 全文下载次数: 0 |
| 中文摘要: |
| 目的:探讨急性嵌顿性闭孔疝的临床诊治经验,回顾相关文献。方法:回顾性分析杭州市第一人民医院2017年1月至2023年12月收治的21例急性嵌顿性闭孔疝患者的一般情况、临床表现、手术过程、术后并发症等临床资料。结果:4例患者手法复位成功,择期手术；17例行急诊腹腔镜探查,5例发生肠坏死或穿孔,行闭孔缝扎术后开腹肠切除,12例患者无肠管问题,行腹腔镜下补片修补。无肠切除的单侧闭孔疝手术时间为23～65(42±18)min,平均住院时间2～7(4.5±2.1)d。术后随访8～48个月,1例在术后2周因补片移位复发并再次手术,2例因肠坏死仅行闭孔口缝扎患者复发并再次行补片修补,无感染、慢性疼痛等并发症发生。结论:闭孔疝的治疗强调早期诊断、早期手术干预。CT是早期发现闭孔疝的重要诊断方法。腹腔镜手术相对传统手术优势更大,可减少肠切除率,术中补片需要固定。 |
| 英文摘要: |
| Objective To explore the clinical experience in treating acute incarcerated obturator hernia with laparoscopic technique and review literature. Methods A retrospective analysis was conducted on the clinical data of 21 patients with acute incarcerated obturator hernia who were treated at Hangzhou First People’s Hospital from January 2017 to December 2023. The analysis included general information, clinical manifestations, surgical procedures, and postoperative complications. Results 4 patients successfully underwent manual reduction and subsequently had elective laparoscopic obturator hernia repair. Among the 17 emergency surgeries, five patients experienced bowel necrosis or perforation and underwent bowel resection following obturator hernia repair with suture. The remaining 12 patients, who had no bowel issues, underwent laparoscopic obturator hernia repair. The operation time for unilateral obturator hernia repair without bowel resection ranged from 23 to 65 minutes (42±18 min), with an average hospital stay of 2 to 7 days (4.5±2.1 days). During the postoperative follow-up period of 8 to 48 months, one patient experienced recurrence due to mesh displacement two weeks after surgery and required another operation. 2 patients who had only undergone obturator orifice suture also experienced recurrence and subsequently underwent mesh repair. The remaining patients had no recurrence, infection, or chronic pain. Conclusion Early diagnosis and surgical intervention are crucial in the treatment of acute incarcerated obturator hernia. CT is an essential diagnostic tool for early detection. Laparoscopic surgery offers significant advantages, including a reduced rate of bowel resection. It is important to ensure proper fixation of the mesh. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
