闭孔疝的临床诊断与治疗分析

Diagnosis and treatment of obturator hernia

目的探讨闭孔疝的临床特征及诊治方法。方法回顾性分析南京医科大学附属南京医院(南京市第一医院)2003年6月至2012年11月收治并经手术证实的7例闭孔疝患者的临床资料。结果 7例患者均行疝修补术,其中因肠管坏死行肠切除术5例,行嵌顿小肠松解复位2例。术后出现肺部感染3例,切口感染2例,痊愈出院5例,死亡2例。结论闭孔疝术前误诊、漏诊率极高,对老年体弱、有多胎生育史伴腹痛、呕吐等肠梗阻表现的患者,需高度警惕闭孔疝的可能,CT检查有利于闭孔疝的早期确诊,及时手术干预对减少该疾病的并发症及致死率是十分必要的。

Objective The aim of this article was to investigate the clinical characteristics, diagnosis and treatment of obturator hernia. Methods From June 2003 to November 2012, the clinical data of 7 cases of obturator hernia were analyzed retrospectively in Nanjing First Hospital, Affiliated to Nanjing Medical University. Results Three patients were confirmed by doing preoperative CT examination, and four cases were diagnosed during the emergency laparotomy. All were performed with hernia repair, five out of seven operated patients required bowel resection, postoperative complications were found in five cases, five patients were cured, and 2 died. Conclusions It is easy to mis-diagnose or ignore the obturator hernia. The elderly, emaciated and multiparous women with intestinal obstruction should be highly suspected this disease. Preoperative CT examination is helpful to early diagnose for obturator hernia, and it is necessary to get a timely surgical intervention for avoiding the complications and mortality related to this disease.