闭孔疝14例诊治分析

Diagnosis and surgical treatment of obturator hernia （a report of 14 cases）

目的探讨闭孔疝术前诊断及外科治疗方法。方法回顾性分析我院自1998年1月至2009年12月收治的14例闭孑L疝患者的临床资料。结果术前诊断为不明原因肠梗阻11例（78．6％），确诊为闭孔疝3例（21．4％）。绞窄疝10例，穿孔6例，行肠切除10例。用聚丙烯补片行疝修补9例，通过腹膜填塞简单缝合修补5例。发生并发症10例，死亡2例。结论对于体瘦、老年、多产妇闭孔疝患者，早期诊断和早期治疗可减少其并发症发生率及死亡率。

Objective To explore the diagnosis and surgical treatment of obturator hernia. Methods The clinical data of 14 patients with obturator hernia who underwent surgical treatment from January 1998 to December 2009 in our hospital were retrospectively analyzed. Result Low body mass index and muhiparity were predisposing factors. Mean time from onset of symptoms to consultation was 3.9 days. Among 11 patients who were preoperatively diagnosed as having intestinal obstruction of unknown eti- ology （78.6%）,3 were confirmed as having obturator hernia（21.4% ）. The rate of strangulated hernias accounting for 71.4% and the perforation rate was 42.8%. Intestinal resection was performed in 10 cases （71.4%）. Hernia repair was performed by using polypropylene mesh in 9 cases and by means of simple suture and apposition of the peritoneum in 5 cases. Morbidity was 71.4% and mortality was 14.2%. Conclusion Early diagnosis and early treatment for patients with obturator hernia who are weak, elderly, or multiparous can reduce complications and mortality.