切换至 "中华医学电子期刊资源库"

中华疝和腹壁外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (06) : 668 -671. doi: 10.3877/cma.j.issn.1674-392X.2022.06.013

临床论著

急诊和择期股疝临床特点及其修补后早期临床效果的回顾性队列研究
谢海亮1, 郑国富1, 郭仪1, 刘云强1, 刘小春1,(), 谢元才1   
  1. 1. 341000 江西省,赣州市人民医院血管疝外科
  • 收稿日期:2022-02-05 出版日期:2022-12-18
  • 通信作者: 刘小春
  • 基金资助:
    赣州市指导性科技计划项目(GZ2018ZSF279)

Clinical characteristics and early outcomes of emergency and elective femoral hernia repair: A retrospective cohort study

Hailiang Xie1, Guofu Zheng1, Yi Guo1, Yunqiang Liu1, Xiaochun Liu1,(), Yuancai Xie1   

  1. 1. Vascular & Hernia Surgery, Ganzhou People's Hospital, Ganzhou 341000, China
  • Received:2022-02-05 Published:2022-12-18
  • Corresponding author: Xiaochun Liu
引用本文:

谢海亮, 郑国富, 郭仪, 刘云强, 刘小春, 谢元才. 急诊和择期股疝临床特点及其修补后早期临床效果的回顾性队列研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2022, 16(06): 668-671.

Hailiang Xie, Guofu Zheng, Yi Guo, Yunqiang Liu, Xiaochun Liu, Yuancai Xie. Clinical characteristics and early outcomes of emergency and elective femoral hernia repair: A retrospective cohort study[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(06): 668-671.

目的

比较急诊和择期股疝的临床特点及修补术后早期临床效果。

方法

回顾性分析2013年1月至2018年12月,赣州市人民医院手术治疗的股疝患者的临床资料,其中择期股疝组53例,急诊股疝组85例。

结果

2组病例均以女性偏多,急诊组较择期组的病程偏长,年龄偏高;急诊组中有并存病的患者较多,以慢性阻塞性肺疾病、肝硬化多见。急诊组和择期组中肠梗阻患者分别为64例和4例,2组术中需肠切除、肠吻合的患者分别为14例和0例,但2组的修补方式差异无统计学意义。术后血清肿和浅表感染急诊组较择期组明显偏多,差异有统计学意义(P<0.05)。术后1个月内急诊组死亡7例,而择期组无死亡病例,K-M曲线分析Log-rank检验,差异有统计学意义(P<0.05)。

结论

急诊股疝合并症较择期股疝多,病程长,术后并发症多,且术后1个月内死亡率高。所以股疝一旦确诊,应及时纠正患者的并存病,尽早手术,或许可以改善股疝患者的预后。

Objective

To compare the clinical characteristics of emergency and elective femoral hernia and the early clinical effects after repair.

Methods

The clinical data of patients with femoral hernia who treated surgically in Ganzhou People's Hospital from January 2013 to December 2018 were retrospectively analyzed, including 53 cases in the elective femoral hernia group and 85 cases in the emergency femoral hernia group.

Results

The cases in both groups were mostly female, and the course of disease in the emergency group was longer and age was higher than those in the elective group. In the emergency group, there were more patients with comorbidities, and the comorbidities were mostly COPD and cirrhosis. There were 64 cases of intestinal obstruction in the emergency group and 4 cases in the elective group, and 14 cases and no case of intestinal anastomosis was required in the two groups, respectively. However, there was no significant difference in the repair methods between the two groups. The complications of postoperative seroma and superficial infection were more frequent in the emergency group than that in the elective group, and the difference was statistically significant (P<0.05). There were 7 deaths in the emergency group and no death in the elective group within one month after surgery, the Kaplan-Meier curve analysis log-rank test showed that the difference was statistically significant (P<0.05).

Conclusion

Complications of emergency femoral hernia were more frequent than those of elective femoral hernia, the course of disease was longer, postoperative complications were more frequent, and the mortality was higher within 1 month after operation. Therefore, once the diagnosis of femoral hernia is confirmed, the patient's comorbidities should be corrected in time, and surgery should be performed as soon as possible, which might improve the prognosis of patients with femoral hernia.

表1 2组患者临床病例特征[例(%)]
表2 2组患者疝内容物及肠梗阻情况[例(%)]
表3 2组手术相关数据、并发症和随访结果
表4 股疝患者并发症相关性分析(n=138)
图1 Kaplan-Meier曲线分析比较2组病例术后1个月内死亡率
[1]
Tastaldi L, Krpata DM, Prabhu AS, et al. Emergent groin hernia repair: A single center 10-year experience[J]. Surgery, 2019, 165(2): 398-405.
[2]
Helgstrand F, Rosenberg J, Kehlet H, et al. Outcomes after emergency versus elective ventral hernia repair: a prospective nationwide study[J]. World J Surg, 2013, 37(10): 2273-2279.
[3]
Kalayci T, Iliklerden UH, Kotan MC. Factors Affecting Morbidity, Mortality, and Recurrence in Incarcerated Femoral Hernia[J]. J Coll Physicians Surg Pak, 2022, 32(2): 213-219.
[4]
Kjaergaard J, Bay-Nielsen M, Kehlet H. Mortality following emergency groin hernia surgery in Denmark[J]. Hernia, 2010, 14(4): 351-355.
[5]
Dahlstrand U, Wollert S, Nordin P, et al. Emergency femoral hernia repair: a study based on a national register[J]. Ann Surg, 2009, 249(4): 672-676.
[6]
Humes DJ, Radcliffe RS, Camm C, et al. Population-based study of presentation and adverse outcomes after femoral hernia surgery[J]. Br J Surg, 2013, 100(13): 1827-1832.
[7]
Beadles CA, Meagher AD, Charles AG. Trends in emergent hernia repair in the United States[J]. JAMA Surg, 2015, 150(3): 194-200.
[8]
Liu X, Zheng G, Ye B, et al. Risk factors for surgical opportunity in patients with femoral hernia: A retrospective cohort study[J]. Medicine(Baltimore), 2018, 97(34): e11826.
[9]
Alhambra-Rodriguez de Guzman C, Picazo-Yeste J, Tenias-Burillo JM, et al. Improved outcomes of incarcerated femoral hernia: a multivariate analysis of predictive factors of bowel ischemia and potential impact on postoperative complications[J]. Am J Surg, 2013, 205(2): 188-193.
[10]
李征威, 张玉新, 王磊, 等. 成人腹股沟嵌顿疝发生肠坏死的危险因素分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2020, 14(4): 433-437.
[11]
Gonzalez-Urquijo M, Tellez-Giron VC, Martinez-Ledesma E, et al. Bowel obstruction as a serious complication of patients with femoral hernia[J]. Surg Today, 2021, 51(5): 738-744.
[12]
Tanaka N, Uchida N, Ogihara H, et al. Clinical study of inguinal and femoral incarcerated hernias[J]. Surg Today, 2010, 40(12): 1144-1147.
[13]
Ge BJ, Huang Q, Liu LM, et al. Risk factors for bowel resection and outcome in patients with incarcerated groin hernias[J]. Hernia, 2010, 14(3): 259-264.
[14]
Dahlstrand U, Wollert S, Sandblom G, et al. Limited Potential for Prevention of Emergency Surgery for Femoral Hernia[J]. World J Surg, 2014, 38(8): 1931-1936.
[15]
Nilsson H, Nilsson E, Angeras U, et al. Mortality after groin hernia surgery: delay of treatment and cause of death[J]. Hernia, 2011, 15(3): 301-307.
[16]
Suppiah A, Gatt M, Barandiaran J, et al. Outcomes of emergency and elective femoral hernia surgery in four district general hospitals: a 4-year study[J]. Hernia, 2007, 11(6): 509-512.
[17]
Kohno S, Hasegawa T, Aoki H, et al. Analysis of risk factors for surgical site infection and postoperative recurrence following inguinal and femoral hernia surgery in adults[J]. Asian J Surg, 2022, 45(4): 1001-1006.
[1] 马东扬, 李斌, 陆安清, 王光华, 雷文章, 宋应寒. Gilbert 与单层补片腹膜前疝修补术疗效的随机对照研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 629-633.
[2] 王浩源, 汪海洋, 孙建明, 陈以宽, 祁小桐, 唐博. 腹腔镜与开放修补对肝硬化腹外疝患者肝功能及凝血的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 654-659.
[3] 周正阳, 陈凯, 仇多良, 邵乐宁, 吴浩荣, 钟丰云. 腹腔镜腹股沟疝修补术后出血原因分析及处理[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 660-664.
[4] 顾熙, 徐子宇, 周澍, 张吴楼, 张业鹏, 林昊, 刘宗航, 嵇振岭, 郑立锋. 腹股沟疝腹膜前间隙无张力修补术后补片感染10 例报道[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 665-669.
[5] 宋俊锋, 张珍珍. 单侧初发性腹股沟斜疝老年患者经腹腹膜前疝修补术中残余疝囊腹直肌下缘固定效果评估[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 670-674.
[6] 高娟, 徐建庆, 闫芳, 丁盛华, 刘霞. Rutkow、TAPP、TEP 手术治疗单侧腹股沟疝患者的临床疗效及对血清炎症因子水平的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 675-680.
[7] 于新峰, 曾琦, 后强, 徐浩, 操谢芳. 腹腔镜经腹腹膜前疝修补术和腹腔镜完全腹膜外疝修补术对成人腹股沟疝治疗效果及预后分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 681-686.
[8] 朱佳琳, 方向, 贵诗雨, 黄丹, 周小雨, 郭文恺. 大鼠切口疝腹膜前间隙补片修补术后血清中VEGF 和Ang-1 的表达情况[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 703-707.
[9] 张晋伟, 董永红, 王家璇. 基于GBD2021 数据库对中国与全球老年人疝疾病负担和健康不平等的分析比较[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 708-716.
[10] 杨媛媛, 林贤超, 林荣贵, 陆逢春, 黄鹤光. 肌后/腹膜前补片修补巨大切口疝术后并发症防治[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 645-648.
[11] 袁志静, 黄杰, 何国安, 方辉强. 罗哌卡因联合右美托咪定局部阻滞麻醉在老年腹腔镜下无张力疝修补术中的应用[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 557-561.
[12] 张锋, 孙孟奇, 方秀春. 静注右美托咪定、利多卡因对腹腔镜疝修补术患者围手术期心率、麻醉苏醒质量的比较[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 562-565.
[13] 何岩, 向文采. 七氟醚与异丙酚联合氯胺酮麻醉在疝修补术中的镇静镇痛效果及安全性[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 566-569.
[14] 丁荷蓓, 王珣, 陈为国. 七氟烷吸入麻醉与异丙酚静脉麻醉在儿童腹股沟斜疝手术中的应用比较[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 570-574.
[15] 刘明辉, 葛方明. MRI 对腹股沟疝修补术后患者早期并发症的评估价值研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 579-583.
阅读次数
全文


摘要