成人腹股沟嵌顿疝的临床治疗策略

Clinical management strategy of adult inguinal incarcerated hernia

成人腹股沟嵌顿疝是疝与腹壁外科常见急腹症,治疗不及时易进展为绞窄性疝,发生肠缺血性坏死、疝外被覆组织的蜂窝织炎、疝囊积脓、肠瘘等,甚至引发中毒性休克,致死率明显增高。腹股沟疝嵌顿类型不同,处理方式不一。基于肌耻骨孔疝修补概念,腹股沟嵌顿疝包括嵌顿斜疝、嵌顿直疝、嵌顿股疝等。笔者认为:目前不同类型腹股沟嵌顿疝的综合治疗尚未形成统一标准,成人腹股沟嵌顿疝的临床处理策略仍面临严峻挑战。

Inguinal incarcerated hernia in adults is a common acute abdomen in hernia and abdominal wall surgery.If not treated in time,it is easy to progress to constrictive hernia,lead to intestinal ischemic necrosis,cellulitis of tegmental tissue outside the hernia,hernia sac empyema,intestinal fistula,and even cause toxic shock,with significantly increased mortality.The types of incarceration are different and the corresponding management methods are different.Based on the proposal of the concept of musculopubic foramen hernia repair,inguinal incarcerated hernia includes incarcerated indirect hernia,incarcerated direct hernia,incarcerated femoral hernia,etc.At present,there is no uniform standard for the comprehensive treatment of different types of inguinal incarcerated hernia,and the clinical management strategies of adult inguinal incarcerated hernia still face serious challenges.