婴幼儿腹股沟嵌顿性斜疝特点与手术年龄的选择

目的 分析婴幼儿腹股沟嵌顿性斜疝的特点,探讨其手术年龄的选择。方法 回顾分析217例婴幼儿(新生儿除外)腹股沟嵌顿性斜疝的临床资料。按年龄分三组:A组为1～6个月,n=66;B组为7～12个月,n=123例;C组为13～24月,n=28例。手术按复杂程度分为单纯术(疝囊高位结扎)和复杂术(疝修补或/和相应并发症的处理)。结果 初次出现斜疝的平均年龄、嵌顿次数三组间无统计学差异(P>0.05)。但性腺损伤的发生率A组高于B组(P<0.01),C组复位失败率低于B组(P<0.05),C组的肠坏死发生率高于A、B二组(P均<0.05)。C组施行复杂术的比例高于A、B组,而A组高于B组(P均<0.05)。结论 小于6个月婴幼儿的嵌顿性斜疝手法复位失败率较高,复杂手术居多,性腺损伤的发生率高。对于这些婴幼儿腹股沟斜疝,应不受年龄的限制,及早采取手术治疗。

Feature of Infantile Inguinal Indirect Herina and Age Selection of Operation

Objective To investigate incarcerated indirect hernia disease clinical data, and to explore choice of surgical age of infant inguinal indirect herina. Method Incarcerated hernia clinical data of 217 infants( neonate excepted) in 1993-2002 were reviewed,group A age was 1-6 months (n=66), group B was 7-12 months (n=123), group C was 1-2 years old (n=28).Simple operation was the high ligation of hernial sac, Complicated operation was the repair of hernia with/or the handling of complications. Complications including sex gland ischemia/necrosis, intestine necrosis,according as complicated degree. Results There was no statistical significance between three groups (P>0.05) in the average age of indirect hernia for the frist attack time and number of incarcerated times, but injuried rate of sex gland in group A higher than that of B group ( P<0.01). Fathermore, the failure rate of replacement in group C less than that of group B. the necrosis of intestine and rate of complicated operation of group C highest than that of A,B groups.However, the necrosis rate complicated with the operation in group A higher than that of group B (P<0.05). Conclusions Higher failure rate of replacement in incarcerated indirect hernia of infants who are less than 6 months,simultaneously, the complicated operation and sex gland injury are higher.The sick infants with inguinal indirect hernia should be surgical treated,as soon as possible,and there is no age limit.