临床外科杂志 ›› 2025, Vol. 33 ›› Issue (4): 429-432.doi: 10.3969/j.issn.1005-6483.20240565

• 论著 • 上一篇    下一篇

基层医院腹股沟疝急诊手术入路选择及效果分析

汪明术   

  1. 237300 安徽省金寨县中医医院普外科
  • 收稿日期:2024-04-16 出版日期:2025-04-20 发布日期:2025-04-20

Selection and effect analysis of emergency surgical approach for inguinal hernia in primary hospital

WANG Mingshu   

  1. Department of General Surgery,Jinzhai Hospital of Traditional Chinese Medicine,Anhui,Jinzhai 237300,China
  • Received:2024-04-16 Online:2025-04-20 Published:2025-04-20

摘要: 目的 比较耻骨上正中切口后入路与传统疝切口前入路急诊手术治疗成人嵌顿性腹股沟疝的临床效果。方法 2019年~2024年急诊手术治疗的成人腹股沟疝病人94例,按手术入路分为两组,观察组47例,采用耻骨上正中切口后入路。对照组47例,采用传统疝切口前入路。比较两组病人的基本资料、手术相关指标、手术并发症。结果 与对照组比较,观察组嵌顿脏器复位时间短(P<0.05),切口并发症发生率及非计划性二次手术率均低于对照组,差异有统计学意义(P<0.05);两组手术时间、术式、肠道并发症及术后睾丸萎缩率比较,差异无统计学意义(P>0.05)。结论 急诊采用耻骨上正中切口后入路治疗成人腹股沟疝,嵌顿脏器复位快捷、切口并发症少、非计划性二次手术率低。

关键词: 嵌顿性腹股沟疝, 急诊手术, 手术入路, 手术并发症, 基层医院

Abstract: Objective To compare the clinical effects of posterior suprapubic median incision approach and anterior hernia incision approach in the treatment of adult incarcerated inguinal hernia.Methods From 2019 to 2024,94 adult patients with inguinal hernia who underwent emergency surgery were divided into two groups according to the surgical approach.There were 47 cases in the observation group,and the approach was adopted after the suprapubic median incision.In the control group of 47 cases,the traditional anterior approach of hernia incision was adopted.The basic data,surgery-related indexes and surgery-related complication indexes of the two groups were compared.Results Compared with the control group,the resetting time of incarcerated organs in the observation group was shorter (P<0.05),the incidence of incision complications and the rate of unplanned reoperation were lower than those in the control group,and the differences were statistically significant(both P<0.05).The operation time,operation completion,intestinal complications and postoperative testicular atrophy rate in the study group were similar to those in the control group,with no statistical significance (P>0.05).Conclusion The use of posterior suprapubic median incision for emergency inguinal hernia surgery in adults has the advantages of fast resetting of incarcerated organs,fewer incision complications,and low rate of unplanned second operation.

Key words: incarcerated inguinal hernia, emergency surgery, surgical approach, surgical complications, primary hospital

[1] 冯波 乃吉普·阿不都艾尼 蔡正昊. 经括约肌间切除术(ISR)的入路方式创新:从ISR国际专家共识谈起[J]. 临床外科杂志, 2024, 32(5): 453-456.
[2] 管国义 刘晨 陈家麟 郑龙龙. 联合入路手术治疗复杂过伸型胫骨平台骨折[J]. 临床外科杂志, 2023, 31(4): 326-329.
[3] 金曜 汪翰 杨帆 陶凯雄 张弦. 腹腔镜技术在嵌顿性腹股沟疝中的应用[J]. 临床外科杂志, 2021, 29(9): 857-859.
[4] 刘继辉, 孙明, 余兵. 纵隔负压引流管在经右胸途径食管癌手术中的应用[J]. 临床外科杂志, 2021, 29(8): 714-716.
[5] 张安平 刘宝华. 腹腔镜右半结肠切除术的手术入路及注意事项[J]. 临床外科杂志, 2021, 29(5): 412-414.
[6] 林天生 陈忠. 胰十二指肠切除术后迟发出血的影响因素及处理策略分析[J]. 临床外科杂志, 2020, 28(9): 867-870.
[7] 宋耀林, 黄杰, 谢颂平等. 颈胸交界处肿瘤28例诊治体会[J]. 临床外科杂志, 2019, 27(9): 805-806.
[8] 康敢军, 黄杰. 颈胸交界处肿瘤的个性化外科治疗[J]. 临床外科杂志, 2019, 27(7): 552-554.
[9] 朱铁源, 范国华, 王土生, 黄杰. 颈部切口联合胸腔镜技术在颈纵隔良性肿瘤切除中的应用[J]. 临床外科杂志, 2019, 27(2): 149-151.
[10] 杜晓辉 何长征. 右半结肠癌微创治疗的术式选择[J]. 临床外科杂志, 2018, 26(10): 724-726.
[11] 陈少珑 黄顺荣. 腹腔镜下中低位直肠癌保肛术23例分析 [J]. 临床外科杂志, 2013, 21(3): 217-218.
[12] 苏清华 周波 纪宗正等. 甲状腺良性病变再手术的原因和预防分析[J]. 临床外科杂志, 2012, 20(9): 630-631.
[13] 吴亚群. 甲状腺手术并发症的原因及预防[J]. 临床外科杂志, 2012, 20(7): 459-460.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 黄洪锋. 关注公民逝世后器官捐献肾移植受体围手术期感染的预防与处理[J]. 临床外科杂志, 2016, 24(10): 732 .
[2] 胡善彪;余少杰;彭龙开. 婴幼儿供肾移植[J]. 临床外科杂志, 2016, 24(10): 741 .
[3] 昌盛. 中国心脏死亡捐献供肾器官的维护[J]. 临床外科杂志, 2016, 24(10): 744 .
[4] 杨华;李新长;龙成美;等. 公民逝世后器官捐献供肾移植临床分析[J]. 临床外科杂志, 2016, 24(10): 747 .
[5] 齐卫鹏;王剑明;刘颜;等. 术前应用靛氰绿检测联合三维重建成像评估肝门部胆管癌肝脏储备功能[J]. 临床外科杂志, 2016, 24(10): 756 .
[6] 阿布力克木·毛拉尤甫;郑秉礼. 胰腺实性假乳头状瘤45例手术治疗分析[J]. 临床外科杂志, 2016, 24(10): 764 .
[7] 胡志伟;汪忠镐;张玉;等. 腹腔镜Toupet胃底折叠术治疗干燥综合征合并严重胃食管反流病两例[J]. 临床外科杂志, 2016, 24(10): 766 .
[8] 胡小平;王志维;邓宏平;等. 改良全主动脉弓置换治疗老年Stanford A型主动脉夹层[J]. 临床外科杂志, 2016, 24(10): 777 .
[9] 戴强;徐康;周治军;等. 湖北天门地区泌尿系结石成分及特征分析[J]. 临床外科杂志, 2016, 24(10): 789 .
[10] 胡光俊;宋晓阳;陶军. 右美托咪定添加到罗哌卡因中对腰丛坐骨神经阻滞及镇静的影响[J]. 临床外科杂志, 2016, 24(10): 796 .