女性婴幼儿嵌顿性腹股沟斜疝致附件坏死的诊治分析  

Diagnosis and treatment of accessory necrosis caused by incarcerated inguinal hernia in female infants

作　　者：张雪琴 Zhang Xueqin(Department of General and Neonatal Surgery,Kunming Children's Hospital,Kunming Medical University,Kunming 650228,China)

机构地区：[1]昆明医科大学附属昆明市儿童医院普通外科及新生儿外科

出　　处：《中华临床医师杂志（电子版）》2019年第12期914-917,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的总结女性婴幼儿嵌顿性腹股沟斜疝致附件坏死的临床特点和治疗经验。方法回顾性分析昆明医科大学附属昆明市儿童医院2014年3月至2018年12月收治的94例女性婴幼儿嵌顿性腹股沟斜疝患儿的临床资料,并对其临床表现、诊断方法和治疗效果进行分析。结果94例患儿均以腹股沟区包块就诊。51例彩色多普勒超声检查考虑附件嵌顿,11例考虑肠管嵌顿,7例考虑网膜嵌顿,25例性质不定;经急诊手术证实,61例附件发生嵌顿,其中19例为附件坏死,3例为肠管嵌顿,30例自行回复;19例附件发生坏死的患儿中,17例予以切除,2例家属拒绝切除予以还纳。1例术后复发。结论女性婴幼儿嵌顿性腹股沟斜疝附件(多为卵巢及部分输卵管)嵌顿坏死发生率相对较高,需早发现、早诊断、早治疗,以减少附件嵌顿坏死手术切除的风险;彩色多普勒超声是诊断附件嵌顿性腹股沟斜疝的重要方法。Objective To sum up the clinical features and therapeutic experiences with accessory necrosis caused by incarcerated inguinal hernia in female infants.Methods A retrospective analysis was performed on the clinical manifestations,examinations,and therapeutic effects in 94 cases of incarcerated inguinal hernia in female infants from March 2014 to December 2018 at Department of General and Neonatal Surgery of Affiliated Kunming Children's Hospital of Kunming Medical University.Results All the 94 cases were found with an inguinal mass.51 cases were considered with accessory incarceration by color Doppler ultrasound,11 cases with intestinal incarceration,7 cases with omental incarceration,and 25 cases with unknown substance incarceration.After emergency operation,61 cases were confirmed with accessory incarceration,19 cases were accessory necrosis,and 3 cases with intestinal incarceration,the rest 30 cases recovered spontaneously.Among the 19 cases of accessory necrosis,17 cases underwent resection and 2 cases refused resection.One case recurred after operation.Conclusion The incidence of accessory necrosis(mostly ovary and part of oviduct)caused by incarcerated inguinal hernia in female infants is relatively high,and it should be diagnosed early and treated promptly to decrease the risk of resection of accessory necrosis.Color Doppler ultrasound is an important method for the diagnosis of incarcerated inguinal hernia with accessory.

关 键 词：女性 婴幼儿 疝 腹股沟 附件 坏死 

分 类 号：R726.5[医药卫生—儿科]