闭孔疝的术前诊断和手术治疗14例临床分析

Diagnosis and surgical treatment of obturator hernia: a retrospective analysis of 14 cases

目的探讨闭孔疝术前诊断和手术方法,为临床诊断和治疗闭孔疝提供参考依旧。方法对我院1985-2005年收治闭孔疝14例闭孔疝的病史,临床表现,影像学检查及手术情况进行回顾性分析。结果早期病例9例均是以发生绞榨性肠梗阻剖腹探查明确诊断,手术采取直接拉拢修补。近期病例5例术前诊断闭孔疝,手术采用B rad补片修补。结论闭孔疝手术中注意闭孔神经压迫症状,特别是Howsh ip-Romberg征对本病有重要意义,腹部CT扫描为标准方法,手术采用补片修补操作简便,安全,可靠。

Objective To explore the diagnosis and surgical method of obturator hernia. Methods The clinical data of 14 cases of obturator hernia from 1985 to 2005 were retrospectively analyzed of the history, clinical manifestation, CT imaging and operation method, Results The diagnosis was made definite after exploratory laparotomy for intestinal obstruction in the early 9 cases, and they adopted patching directly. The diagnosis of the later 5 cases was made before operation, and they applied Brad mesh patching. Only three patients died after operation, 2 owing to infecive shock and 1 to respiratory failure caused by pulmonary infection. Conclusion Howship-Romberg sign is important in diagnosing obturator hernia. The abdomen CT scanning is the standard method. Brad mesh patching is simple, safe and reliable in treating obturator hernia.