闭孔疝诊治的探讨

Diagnosis and therapy for obturator hernia

目的总结闭孔疝的诊断和治疗经验。方法对我院1980～2003年收治的45例闭孔疝患者的临床资料进行回顾分析。将45例患者按是否行螺旋CT(CAT)检查分为两组(A组24例,行CAT;B组21例,未行CAT)。结果术前确诊率A组(95.83%,23/24)较B组(52.38%,11/21)明显高(P<0.05)。肠切除率和病死率A组(45.83%,11/24;4.17%,1/24)较B组(85.71%,18/21;23.81%,5/21)明显低(P<0.02和0.05)。结论盆腔CAT在可疑闭孔疝患者中的应用可显著提高术前确诊率和降低肠切除率及外科病死率。

Objective To study the diagnostic and therapeutic experiences for patients with obturator hernia.Methods Patients with obturator hernia undergoing surgery at west China hospital were divided retrospectively into two groups(group A=12 patients having been checked by computed axial tomography[CAT];group B=24 patients without CAT applied).Results Rate of preoperative diagnosis in group A at 95.83%(23/24)was significantly higher than in group B at 52.38%(11/21)(P<0.05).Rate of intestinal resection and motality in group A at 45.83%(11/24)and 4.17%(1/24)were lower significantly than in group B at 85.71%(18/21)and 23.81%(5/21)(P<0.02 and 0.05,respectively).Conclusions The use of pelvic CAT in cases of suspected obturator hernia significantly enhances preoperative diagnostic accuracy and help to decrease both rate of intestinal resection and surgical mortality.