探究超声检查在合并病态肥胖无症状隐匿性肥胖腹股沟疝诊断中的应用。

回顾性分析2017年11月至2019年11月，芜湖市中医医院合并病态肥胖无症状隐匿性肥胖腹股沟疝患者66例，所有患者均在行高频超声检查时偶然发现无症状腹股沟疝，记录患者行超声检查时的声像特征，以手术结果为金标准，计算超声诊断无症状隐匿性肥胖腹股沟疝的灵敏度、特异度及准确率。

66例超声诊断合并病态肥胖无症状隐匿性腹股沟疝患者中58例行手术治疗，54例确诊为腹股沟疝，3例为股疝，1例为淋巴结肿大。剩余8例经保守治疗后症状改善，定期随访病情无进展。以手术为金标准，超声诊断无症状隐匿性肥胖腹股沟疝的灵敏度、特异度、准确率分别为91.38%（53/58）、16.67%（1/6）和87.10%（54/62）。

超声诊断合并病态肥胖无症状隐匿性腹股沟疝的效能较高，但仍存在假阴性的情况，病态肥胖可能成为影响腹股沟疝超声诊断的因素，临床上对于疑似腹股沟疝的肥胖患者需注重体格检查和临床鉴别，必要时行手术探查。

To explore the application of ultrasonography in the diagnosis of asymptomatic occult inguinal herniain patients with morbid obesity.

66 patients with asymptomatic occult inguinal hernia and morbid obesityin Wuhu Hospital of Traditional Chinese Medicine from November 2017 to November 2019 were enrolled in the study. All patients were diagnosed with asymptomatic inguinal hernia unintentionally by high-frequency ultrasound examination. The ultrasonic image characteristics were recorded, and the surgical results were taken as the gold standard. The sensitivity, specificity and accuracy of ultrasound in the diagnosis of asymptomatic occult inguinal hernia in obese patients were analyzed.

58 of the 66 patients with morbid obesity and asymptomatic occult inguinal hernia diagnosed by ultrasound were treated with surgery, and 54 were diagnosed as inguinalhernia, 3 cases were femoral hernia, 1 case was lymphadenopathy. The symptoms of the remaining 8 cases improved after conservative treatment, and there was no progress in regular follow-up. With surgery as the gold standard, the sensitivity, specificity and accuracy of ultrasound in the diagnosis of asymptomatic occult inguinal hernia in obese patients were 91.38% (53/58), 16.67% (1/6) and 87.10% (54/62), respectively.

Ultrasound diagnosis of asymptomatic inguinal hernia combined with morbid obesity is highly effective, but there are still false negatives. Morbid obesity may become a factor affecting the ultrasound diagnosis of inguinal hernia. Clinically, obese patients with suspected inguinal hernia should pay attention to physical examination and clinical identification, and perform surgical exploration if necessary.