ObjectiveTo evaluate the lesion detection rate and completeness rate of the preoperative ultrasonic diagnosis in patients with external abdominal hernia， and to analyze the quality of preoperative ultrasonic reports， thereby exploring potential improvement measures.MethodsWe conducted a retrospective analysis of clinical data， ultrasonic examination results， and surgical records from patients with external abdominal hernias who underwent surgery at Peking Union Medical College Hospital from January to December 2023.With intraoperative diagnosis as the gold standard， the lesion detection rate were evaluated， and the quality of the reports was evaluated based on whether they indicated the type of inguinal hernia， the width of the neck of the hernia sac and its mobility.ResultsA total of 112 patients with surgically treated external abdominal hernias were included in the study， comprising 98 cases of inguinal hernia and 14 cases of abdominal wall hernia.The preoperative ultrasonic lesion detection rate of inguinal hernia was 95.9%， and the completeness rate of the ultrasound report of inguinal hernia was 14.3%.The preoperative ultrasonic lesion detection rate of ventral hernia was 100.0%， and the completeness rate of the ultrasound report of ventral hernia was 50.0%.ConclusionUltrasound demonstrates a high detection rate for external abdominal hernias， effectively providing information regarding location， size， neck width of the hernia sac， mobility characteristics and relationships with surrounding tissues.Consequently， it is recommended that more comprehensive information be included in ultrasound reports to assist clinicians in making decisions and treatment.
Objective:To investigate the application value of color Doppler ultrasound in the differential diagnosis of inguinal hernia and femoral hernia.Methods:The data of 107 patients with inguinal hernia and femoral hernia who were admitted to Lujiang County People's Hospital, Anhui Province from October 2021 to September 2022 were analyzed retrospectively. All patients underwent color Doppler ultrasonography before surgery, and the examination results were analyzed. The value of color Doppler ultrasound in the differential diagnosis of inguinal hernia and femoral hernia was discussed.Results:All 107 patients were confirmed by surgery including 75 cases of indirect hernia, 20 cases of direct hernia and 12 cases of femoral hernia. Color Doppler ultrasound found 73 cases of indirect hernia, 19 cases of direct hernia and 12 cases of femoral hernia, and 3 cases were misdiagnosed as lipoma. The sensitivity and specificity of color Doppler ultrasound were 96.00% and 96.87% for diagnosing indirect hernia, 95.00% and 96.55% for diagnosing direct hernia, 100.00% and 100.00% for diagnosing femoral hernia .Conclusion:Color Doppler ultrasound has high sensitivity and specificity for diagnosing inguinal hernia and femoral hernia. It can provide reference for the development of surgical plan and adjustment of details.
Objective:To explore the effect of health management combined with psychological intervention in children after laparoscopic inguinal hernia surgery.Methods:In this prospective study, 193 children with inguinal hernia who underwent laparoscopic ligation of hernia sac surgery at Nanning Maternity and Child Health Hospital from July 2020 to June 2022 were selected as the research subjects and were divided into observation group (97 cases) and control group (96 cases) by simple random number table method. The children in the control group received routine nursing and psychological intervention, and the children in the observation group received health management combined with psychological intervention on this basis. The postoperative recovery, postoperative complications, psychological status before and after intervention and parents' satisfaction with nursing were compared between the two groups.Results:The ambulation time, exhaust time, defecation time and hospital stay of the observation group were shorter than those of the control group, and the FLACC score at 24 h after operation was lower than that of the control group (All P<0.05). Before intervention, there was no differences in the scores of CSDC dimensions and total scores between the two groups (P>0.05). After intervention, the scores of CSDC dimensions and total scores in the two groups were lower than those before intervention, and those in the observation group were lower than those in the control group (P<0.05). The difference of each CSDC dimension and total score before and after intervention in the observation group was greater than in the control group (P<0.05). The total incidence of postoperative complications in the observation group was lower than that in the control group (P<0.05). The total nursing satisfaction of parents in the observation group was better than that in the control group (P<0.05).Conclusion:Health management combined with psychological intervention can promote the recovery of children after laparoscopic inguinal hernia surgery, improve the psychological state of children, reduce the incidence of postoperative complications, and improve the nursing satisfaction of parents.
Objective:To explore the application effect of operating room nursing process based on continuous quality improvement in open inguinal hernia repair.Methods:A total of 110 patients with inguinal hernia undergoing open herniorrhaphy with seven-step method in Beijing Tiantan Hospital Affiliated to Capital Medical University were enrolled between January 2020 and December 2022. According to the implementation of operating room nursing program based on continuous quality improvement, they were divided into control group (55 cases, before implementation, between January 2020 and June 2021) and observation group (55 cases, after implementation, between July 2021 and December 2022). The operation time, incidence of postoperative incision infection, surgical cooperation of nursing staffs, surgical cooperation of nursing staffs, standardization of operation by nursing staffs (aseptic operation, surgical procedure and hand hygiene operation), overall nursing quality of operating room, and patients satisfaction were compared between the two groups.Results:Compared with the control group, the operation time was shorter [(80.84±3.58) min vs (82.59±4.21) min], surgical cooperation was better [(9.12±0.14) scores vs (8.25±0.68) scores], and overall satisfaction was higher (90.91% vs 76.36%) in the observation group, with statistical significance (P<0.05). The incidence of incision infection in the observation group was lower than that in the control group, but the difference was not statistically significant (P>0.05). The standardization scores of aseptic operation, surgical procedure and hand hygiene operation by nursing staffs, and scores of overall nursing quality in operating room (environmental management, items placement, disinfection and isolation, registration of nursing documents) in the observation group were improved compared with those in the control group (P<0.05).Conclusion:The operating room nursing process based on continuous quality improvement can effectively improve intraoperative doctor-nurse cooperation, shorten the operation time, improve overall nursing quality of operating room and patients satisfaction, which may reduce the incidence of incision infection. However, it needs to be further observed in a large sample study.
Objective:To analyze the feasibility and safety of laparoscopic totally extraperitoneal hernia repair in the treatment of the right inguinal hernia with history of appendectomy.Methods:From September 2020 to September 2022, the clinical data of 73 patients with right or bilateral inguinal hernia who underwent laparoscopic totally extraperitoneal hernia repair (TEP) at the General Surgery Department of the 991st Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army was retrospectively analyzed. According to whether they had a history of appendectomy, they were divided into a study group (after appendectomy group) and a control group (without surgery history group). The operation-related indicators,, postoperative pain degree, postoperative recovery, total hospitalization cost, and incidence of complications were compared between the two groups.Results:All the patients in the two groups successfully underwent TEP with no perioperative death; the operative time, intraoperative blood loss, hernia sac diameter, incidence of intraoperative peritoneal injury, number of intraoperative peritoneal injuries, amount of plastic clamp used and incidence of medical glue used in the two groups were not statistically significant (P>0.05). No case in the study group was converted to the transabdominal preperitoneal hernia repair (TAPP) or open surgery, and 2 cases in the control group were converted to TAPP, but there was no significant difference in the convert rate between the two groups (P=0.504). There was no significant difference in the time to get out of bed, postoperative hospital stay, or total hospitalization cost between the two groups. There was no significant difference in the VAS score of the postoperative day, the VAS score of the next day, or the postoperative pain duration between the two groups. There were 2 cases of seroma and 1 case of bladder injury in the study group, and 5 cases of seroma and no bladder damage in the control group. In all cases, the follow-up time was 2 to 24 months, and the middle follow-up time was six months. There was no chronic pain in either group. There was no recurrence in the study group, but one recurrence in the control group. There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05).Conclusion:TEP is safe and feasible in the treatment of the right inguinal hernia with a history of appendectomy.
