探讨成人嵌顿性腹股沟疝患者术前炎性指标、CT征象与肠缺血性坏死的关系，并描述不同干预时机下的术式选择及近期结局。

采用单中心回顾性队列设计。回顾性分析2022年11月至2025年2月楚雄彝族自治州人民医院收治的57例成人嵌顿性腹股沟疝患者的临床资料。按初始干预分为急诊手术组（34例）和平诊手术组（23例）。平诊手术组包括手法复位成功15例及短期观察8例，均于同次住院期间手术，实际间隔为1~4 d。记录2组患者的炎性指标（白细胞计数、C反应蛋白、中性粒细胞/淋巴细胞比值）、CT征象、手术方式、肠切除、补片修补及并发症。

平诊手术组年龄[（58.1±16.9）岁比（67.1±13.2）岁，t=2.254，P=0.028]、术前炎性指标升高比例[4.3%（1/23）比58.8%（20/34），P<0.001]均低于急诊手术组。7例不可逆性肠缺血性坏死患者均伴炎性指标升高及至少1项CT缺血相关征象，均在急诊手术组并行肠切除。平诊手术组病历、手术记录及随访中未记录到临床诊断的迟发性肠坏死。平诊手术组腹腔镜术式应用比例较高。2组共有5例发生术后并发症，均经保守处理后好转。

本队列中肠坏死病例均同时存在炎性指标升高和CT缺血相关征象。对经综合评估严格筛选的低风险患者，手法复位后同次住院期间安排平诊手术可能可行；本研究观察到的1~4 d不应解读为经验证的最佳时间窗。

To evaluate the association of preoperative inflammatory markers and CT findings with bowel ischemic necrosis in adults with incarcerated inguinal hernia and to describe the selection of surgical procedure and short-term outcomes according to different timing of intervention.

This was a single-center retrospective cohort study. Clinical data of 57 adults patients with incarcerated inguinal hernia admitted to Chuxiong Yi Autonomous Prefecture People's Hospital between November 2022 and February 2025 were retrospectively analyzed. Patients were divided as emergency surgery group (n=34) or scheduled surgery group (n=23) according to the initial intervention. The scheduled group comprised 15 patients after successful manual reduction and 8 after short observation; all underwent surgery during the same admission, with an observed interval of 1-4 days. Inflammatory markers (white blood cell count, C-reactive protein, neutrophil-to-lymphocyte ratio), CT findings, operative approach, bowel resection, mesh repair, and complications of the two groups were recorded.

The scheduled group was younger than the emergency group [(58.1±16.9) versus (67.1±13.2) years, t=2.254, P=0.028] and had a lower proportion of elevated inflammatory markers [4.3% (1/23) versus 58.8% (20/34), P<0.001]. All seven patients with irreversible bowel ischemic necrosis had elevated inflammatory markers and at least one CT sign related to ischemia; all underwent bowel resection in the emergency group. No clinically diagnosed case of delayed bowel necrosis was documented in the scheduled group based on medical records, operative findings, and follow-up. Laparoscopic procedures were performed more frequently in the scheduled group. A total of five patients in the two groups developed postoperative complications, all of which resolved after conservative management.

In this cohort, every case of bowel necrosis was accompanied by elevated inflammatory markers and CT findings related to ischemia. Scheduled surgery during the same admission after manual reduction may be feasible in carefully selected low-risk patients; the observed 1-4 days interval should not be interpreted as a validated optimal time window.