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目的总结婴幼儿腹股沟嵌顿疝并急性出血性肠炎的诊治经验,提高对该病的认识。方法对本院2005年10月-2010年10月收治的7例腹股沟嵌顿疝并急性出血性肠炎的患儿入院时的临床表现、实验室检查、手术及病情转归等情况进行回顾性分析。结果 7例患儿入院后予补液等处理后均立即行手术治疗。其中5例行腹股沟嵌顿疝松解复位加疝囊高扎术后,因腹胀等再次行肠减压、肠系膜封闭术;2例因肠管坏死穿孔中转开腹。术后均使用亚胺培南-西司他丁或亚胺培南-西司他丁加万古霉素抗感染处理。本组治愈4例,死亡3例。结论早期诊断、积极手术治疗,术前纠正脱水、酸碱紊乱及电解质失衡,术后加强抗感染是治疗腹股沟嵌顿疝并急性出血性肠炎的关键。
Objective To summarize the diagnosis and treatment of infantile inguinal hernia with acute hemorrhagic enteritis and to improve the understanding of the disease. Methods A retrospective analysis was performed on the clinical manifestations, laboratory tests, operation and prognosis of 7 children admitted with inguinal hernia and acute hemorrhagic enteritis admitted to our hospital from October 2005 to October 2010. . Results 7 cases of children admitted to hospital after treatment, such as rehydration immediately after surgery. Among them, 5 cases underwent inguinal hernia repair and ligation of hernia sac and ligation of the hernia sac due to abdominal distension, followed by intestinal decompression and mesenteric occlusion. Two cases underwent open laparotomy due to bowel necrosis and perforation. Postoperative imipenem - cilastatin or imipenem - cilastatin plus vancomycin anti-infective treatment. In this group, 4 cases were cured and 3 died. Conclusion Early diagnosis, active surgical treatment, preoperative correction of dehydration, acid-base disorders and electrolyte imbalance, postoperative anti-infective infection is the treatment of inguinal hernia and acute hemorrhagic enteritis is the key.