27例股疝的临床诊疗体会

目的 总结股疝的临床特点、股疝诊断及手术方式选择。方法 回顾性分析合肥市第三人民医院2007年5月至2016年2月收治的27例股疝患者的临床资料。结果 27例患者以40岁以上女性多见,难复性股疝11例,嵌顿性股疝11例（5例为绞窄）,易复性股疝5例;2例患者拒绝手术治疗,25例手术治疗。手术患者中,行常规McVay疝修补手术8例,行嵌顿松解+单纯高位结扎5例（小肠切除术3例）,行无张力修补术12例（嵌顿松解+无张力修补术2例）,手术患者均采用开放式腹股沟韧带上入路手术。痊愈患者25例,1例患者拒绝手术,保守治疗后出院,1例患者签字放弃治疗,出院后死亡。随访手术患者均无复发。结论 股疝症状不典型,极易嵌顿,病情进展快,尤其高龄患者,早期诊断,及时手术是股疝治疗的关键,手术风险可控,效果明显。

Clinical experience of 27 cases of femoral hernia

Objective To explore the clinical features of femoral hernia, diagnosis and selection of surgical methods.Methods The clinical data of 27 cases from May 2007 to February 2016 in the Third People''s Hospital of Hefei were retrospectively analysed.Results Twenty-seven cases of patients were more than 40 yearsold.Irreducible femoral hernia was in 11 cases,incarcerated hernia in 11 cases(5 cases of strangulation),andreducible femoral hernia in 5 cases.Two cases of patients signed to refuse surgical treatment, and 25 cases were treated by surgery. Conventional McVayhernioplastywas performed in 8 cases, embedded Bolton loose solution and simple ligation in 5 cases(small intestinal resection in 3 cases), and tension free repair in 12 cases(Embedded solution+tension-free repair of Bolton loose in 2 cases). All patients underwent open inguinal ligament repair.In this groupof patients, 25 cases were curedandone patient refused surgery and received conservative treatment after discharge. One patient signed up for abandoning treatment and died after discharge. All patients were followed up with no recurrence.Conclusion Femoral hernia has untypicalsymptoms, is easily incarcerated and has rapid progression. Especially for elderly patients, early diagnosisand timely surgery are the key to the treatment of femoral hernia, with controllable surgical risksand obvious effect.