超声在腹股沟疝无张力修补术后补片感染伴积液诊治中的应用体会

Application experience of ultrasound in diagnosis and treatment of pach infection with effusion after Tension-free repair of inguinal hernia

目的总结腹股沟疝无张力修补术后补片感染的声像图特点及超声引导下穿刺抽液在局部积液治疗中的应用价值。方法回顾分析6例腹股沟疝术后补片感染伴周围积液患者的临床资料,以及影像和相关实验室检查结果,重点分析其声像图特征,并对局部积液行超声引导下穿刺抽液,均送细菌培养。结果 5例患者腹股沟区肿胀疼痛,1例合并窦道形成。其中2例补片部分折叠呈不规则弧形强回声,2例积液内呈细密分隔状,1例患者腹股沟区至阴囊肿胀疼痛,超声显示补片完整,于补片外侧原疝囊区至阴囊区可见局限性积液。遂采取相应对症治疗方法后全部患者均病情好转。结论超声能够动态观察腹股沟疝补片修补术后补片的形态、位置及局部积液情况,为制定个体化治疗方案提供依据,结合超声引导下穿刺抽液,使治疗更加精准化,可取得良好的治疗效果。

Objective To summarize the ultrasonographic features of patch infection after tension-free hernia repair and to evaluate the value of ultrasound-guided drainage in the treatment of local effusion.Methods We retrospectively analysed clinical data of 6 cases of postoperative infection with effusion in the inguinal hernia patch repair,as well as images and related laboratory results,focused on the analysis of ultrasonic image characteristics,and punctured the local fluid under the ultrasound-guidance.The six specimen of effusion were all got a germicultuer respectively.Results 5 patients appeared singuinal region swelling and pain,1 case presented with cutaneous sinus formation.In 2 cases,part of the patch fold showed an irregular arc with strong echo.2 cases were minute separation inside.In one patient,the inguinal area was swollen with pain,and the ultrasound showed that his patch was complete,and the localized fluid was visible in the area of the outside of the patch to the scrotum.The patients were treated with corresponding treatment and finally all patients were improved.Conclusion Ultrasound can dynamically observe the shape,location and local hydrops of the patchafter inguinal hernia patch repair,and provide the basis for individualized therapeutic schedule.Through the combination of ultrasound-guided puncture drainage,the treatment can be more accurate and can achieve good therapeutic effect.