嵌顿疝及绞窄性疝的诊疗方法分析

Analysis of Diagnosis and Treatment of Incarcerated Hernia and Strangulated Hernia

目的:探讨分析嵌顿疝及绞窄性疝的诊疗。方法:选取笔者所在医院2012年5月-2014年11月接收治疗的35例嵌顿疝或绞窄性疝患者作为研究对象,分析手法复位的选择时机及治疗效果,同时对比分析切除肠段患者与未切除肠段患者再次手术、切口感染、平均住院时间、死亡及疝复发情况。结果:所选患者中6例患者采用手法复位,其中1例再次手术;29例患者采取手术进行治疗,未切除肠段组患者再次手术率高于切除肠段组,差异有统计学意义(P<0.05),两组切口感染率、住院时间比较差异无统计学意义(P>0.05),两组患者均未出现死亡病例和复发病例。结论:嵌顿疝及绞窄性疝患者,应结合实际情况选择治疗方法,嵌顿疝采用手法复位后,医护人员需密切关注患者状况,排除肠坏死和假复位状况,在询问病史及体格检查时,及时发现绞窄性疝,早期解除嵌顿,减少死亡风险。在进行手术治疗前,详细评估患者身体状况,充分术前准备;手术过程中,则应仔细检查嵌顿肠段,根据患者局部条件和全身状况给予不同的治疗方式,最大程度上为患者康复提供有利条件。

Objective： To investigate the diagnosis and treatment of incarcerated hernia and strangulated hernia.Method： 35 cases of incarcerated hernia or strangulated hernia patients in our hospital from May 2012 to November 2014 were selected as the research objects.The timing and treatment effect of manipulative reduction were analyzed.The situation of reoperation, wound infection, average duration of hospitalization, mortality and recurrence of hernia were analyzed and compared between intestinal segment excision patients and no bowel resection patients.Result： 6 cases were treated by manual reduction, including 1 case of reoperation.29 patients received surgery.The reoperation rate of patients without bowel resection was higher than patients with bowel resection, the difference was statistically significant（P〈0.05）：The incision infection rate, average hospitalization time of the two groups were not statistically significant（P〉0.05）. There were no death and recurrence patients in the two groups.Conclusion： Patients with incarcerated hernia and strangulated hernia shall be treated according to the actual situation.After incarcerated hernia receiving manipulative reduction, health care workers need to pay close attention to the situation of patients in order to eliminate intestinal necrosis and false reset condition.When asking medical history and giving physical examination, timely detection of strangulated hernia and early termination of incarceration can reduce the risk of death.Before surgery, the patient＇s physical condition is evaluated before surgery, and the surgical procedure is to be carefully examined.In the process of operation, the incarcerated intestinal segment is carefully examined, different treatment methods shall be given to patients according to their local conditions and general situation in order to provide favorable conditions for patients＇ rehabilitation.