闭孔疝的诊断和治疗

目的探讨闭孔疝的诊治方法。方法对15例闭孔疝病例诊治经过结合相关文献进行回顾性分析。结果15例中,术前确诊率仅20%(3/15),误诊率80%(12/15),全组均行疝环修补术,采用剖腹探查切口。本组治愈率100%,术后切口感染及愈合不良4例(21.67%),随访8例至今无复发。结论术前易误诊、漏诊;对年老体弱、多胎生育伴有不明原因肠梗阻表现的妇女,应高度考虑闭孔疝,Howship-Romberg征及Hannington-Kiff征阳性可确诊。疝环修补术是惟一有效的方法,首选腹腔内入路。早确诊,及时手术是减少并发症、降低死亡率的关键。

Diagnosis and treatment of obturator hernia

Objective To investigate the diagnosis and treatment of obturator hernia. (Methods)Diagnosis and treatment of obturator hernia in 15 cases of patients were reviewed retrospectively. (Results) Among the 15 cases, the preoperative diagnostic rate was only 20% (3/15), and the misdiagnostic rate was 80% (12/15). 15 cases were treated by Hernia ring fix operation, and the curative rate were 100% without death and intestinal fistula. Postoperation infection and bad healing were found in 4 cases (21.67%). Follow-up data of 8 cases showed no relapse. Conclusions Misdiagnosis and missed diagnosis of obturator hernia are not rare. The old and multiparous women suffering from bowel obstruction without definite reasons should be highly suspicious for obturator hernia. The positive Howship-Romberg and Hannington-Kiff signs can confirm the diagnosis. The only effective treatment is the ventral incision hernia ring fix operation. Early diagnosis and operation are the key to reduce the complications and mortality related to this disease.