Wang Zihan,Luo Yu,Liu Dong,et al.Analysis of risk factors of ovarian strangulation and necrosis due to incarcerated inguinal hernia in female infants[J].Journal of Clinical Pediatric Surgery,,21():764-768.[doi:10.3760/cma.j.cn101785-202108009-011]
Analysis of risk factors of ovarian strangulation and necrosis due to incarcerated inguinal hernia in female infants
- Keywords:
- Hernia; Inguinal/SU; Ovary/PP; Femininity; Infant; Child
- Abstract:
- Objective To explore the risk factors of ovarian strangulation and necrosis due to incarcerated inguinal hernia in female infants.Methods From February 2014 to December 2020,retrospective analysis was performed for 79 female infants of incarcerated inguinal hernia with strangulated ovary.All cases underwent emergency surgery.Based upon the prognosis of incarcerated ovaries,they were divided into two groups of ovarian necrosis (n=19) and non-necrosis (n=60).Patient demographics,clinical signs,preoperative examinations and intraoperative findings were compared between two groups and the risk factors of ovarian necrosis examined by univariate and multivariate Logistic regression analyses.Results Ovarian necrosis occurred in 19/79 patients with an incidence rate of 24.1%.Single variate analysis revealed that inguinal mass with localized erythema,leucocyte count,ovarian vascularity,ovarian volume and ovary torsion were correlated factors of strangulated ovarian necrosis (P<0.05);Multivariate analysis showed that greater ovarian volume,an absence of ovarian vascularity and ovarian torsion were the independent risk factors of strangulated ovarian.The area under the curve (AUC) of ovarian strangulation necrosis predicted by ovarian volume ≥ 2.02 cm3 was 0.874(95%CI=0.774-0.9774;P=0.000) with a sensitivity of 89.5% and a specificity of 71.7%.Conclusion The clinical manifestations of incarcerated inguinal hernia with ovarian are non-typical.Gynecological ultrasonography remains a primary diagnostic tool.An absence of ovarian vascularity,greater ovarian volume and ovarian torsion are the risk factors of strangulated ovarian necrosis.Ovarian volume ≥ 2.02 cm3 should raise a high alert for ovarian necrosis.
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Memo
收稿日期:2021-8-5。
基金项目:国家自然科学基金项目(81770512);深圳市医疗卫生三名工程项目(SZSM201812055)
通讯作者:王斌,Email:szwb1967@126.com