Inguinal Hernia in Premature Infants.
Inguinal Hernia in Premature Infants.
复制标题
早产儿腹股沟疝气。
DOI：
10.1542/neo.21-6-e392
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Dana C Bichianu
中科院分区：
文献类型：
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作者：
V. Ramachandran;Charles F Edwards;Dana C Bichianu
腹股沟疝是影响新生儿重症监护室婴儿的常见问题。作为一个群体，早产儿腹股沟疝的发病率最高，这种风险随着胎龄的减少而增加。导致腹股沟疝发展的病因尚不清楚，改变这些因素的干预措施尚未得到彻底的研究。腹股沟疝的诊断通常很简单，但有时很难确定疝是绞窄的还是单纯的梗阻。很少，调查方式，如超声检查，可能需要排除其他潜在的原因。在这个人群中，理想的手术修复时间是未知的，并且由于合并症和有限的随机对照试验而变得复杂。在手术中，选择局部麻醉还是全身麻醉需要基于团队的方法，研究发现，更多的临床经验与较低的发病率相关。疝气手术的技术范围从开放到腹腔镜修复，并在小型前瞻性研究中进行了调查，而更大的数据库已用于回顾性分析结果。
Inguinal hernia is a common problem affecting infants in the NICU. As a group, preterm infants have the highest incidence of inguinal hernia and this risk increases as gestational age decreases. The etiopathologic factors leading to the development of an inguinal hernia are not clear and interventions to alter these factors have not been thoroughly investigated. Diagnosis of an inguinal hernia is often straightforward, but occasionally it may be difficult to determine if the hernia is strangulated or simply obstructed. Rarely, investigative modalities, such as ultrasonography, may be needed to rule out other potential causes. The ideal timing of surgical repair in this population is unknown and complicated by comorbid conditions and limited randomized controlled trials. During surgery, the choice of regional versus general anesthesia requires a team-based approach and studies have found that greater clinical experience is associated with lower morbidity. The techniques of hernia surgery range from open to laparoscopic repair and have been investigated in small prospective studies, while larger databases have been used to analyze outcomes retrospectively.