| Objective : To analyze the neutrophil-lymphocyte ratio(NLR),red blood cell distribution width(RDW),procalcitonin(PCT),and D-dimer(D-Dimer)in patients with incarcerated hernia in simple incarcerated hernia.The expression level at the time of occurrence and when incarcerated intestinal necrosis occurs,aims to provide a clinical reference for judging whether the intestinal tube is necrotic and whether intestinal resection is necessary during the treatment of incarcerated hernia,and reduces the judgment error of subjective factors.Methods:This study collected 97 patients with incarcerated hernia who met the inclusion criteria from November 2020 to December 2021 in Abdominal endoscopic surgery · Hernia Center Affiliated Hospital of Qing Hai Hospital.The surgical anesthesia method of the two groups was general anesthesia.The neutrophillymphocyte ratio(NLR),red blood cell distribution width(RDW),neutrophillymphocyte ratio(NLR),red blood cell distribution width(RDW),Difference and correlation analysis of procalcitonin(PCT)and D-dimer(D-Dimer)expression.Results: In this study,we collected 97 patients undergoing incarcerated hernia surgery.The age of the patients ranged from 26 to 89 years(58.628±15.552),with a median age of 59 years,including 76 males(78%)and 21 females(22%).Surgical treatment of 62 cases of incarcerated inguinal hernia(including 50 cases of indirect inguinal hernia,12 cases of direct inguinal hernia),22 cases of femoral hernia,13 cases of incarcerated incisional hernia.Forty-eight patients(49%)were found to have intestinal necrosis during operation and underwent intestinal resection.The preoperative neutrophil-lymphocyte ratio(NLR),red blood cell distribution width(RDW),procalcitonin(PCT)in the intestinal resection group were),and D-dimer(DDimer)were significantly higher than those in the non-resection group.The preoperative NLR values of incarcerated hernia intestinal necrosis group and simple incarcerated hernia group were(7.385±2.841 VS 4.124±2.124),and the difference was statistically significant(P<0.05).RDW:(14.859%±2.891% VS12.984%±2.318%),the difference was statistically significant(P<0.05).PCT:(1.412±0.205 VS 0.372±0.196),the difference was statistically significant(P<0.05).Ddimer was(2.352±0.301 VS 1.181±0.395),the difference was statistically significant(P<0.05).The NLR values on the first day after operation were(6.464±2.336VS3.784±2.131),and the difference was statistically significant(P<0.05).RDW:(13.215%±2.116% VS 12.381%±2.158%),the difference was statistically significant(P<0.05).PCT:(1.646±0.247 VS 0.571±0.279)The difference was statistically significant(P<0.05).The difference of D-dimer(1.823±0.217 VS 0.754±0.206)was statistically significant(P<0.05).The NLR on the 3rd day after operation was(3.583±1.919 VS 3.159±1.294)respectively.After statistical analysis,P>0.05.RDW(12.686%±2.068% vs 12.204%±1.842%).The difference was not statistically significant(P>0.05).PCT:(0.567±0.125 VS 0.466±0.121).The difference was statistically significant(P<0.05).D-dimer(0.568±0.149 vs 0.442±0.125).The difference was statistically significant(P<0.05).The NLR,RDW,PCT and D-Dimer of the incarcerated hernia intestinal necrosis group were higher than those of the nonnecrosis group before and 1 day after operation(P<0.05).There was no significant difference in NLR and RDW between the two groups 3 days after operation.There were significant differences in PCT and D-dimer between the two groups.Conclusion:The preoperative levels of NLR,RDW,PCT and D-Dimer in patients with incarcerated hernia with intestinal necrosis were higher than those in patients with simple incarcerated hernia.When NLR,RDW,PCT,and D-Dimer are significantly elevated,we should be alert to the occurrence of intestinal necrosis in incarcerated hernia.Carry out early diagnosis,implement emergency surgical intervention as soon as possible,remove necrotic bowel,and prevent the occurrence of related complications that endanger the patient’s life.In addition,the dynamic monitoring of NLR,RDW,PCT,D-Dimer levels before surgery,1 day after surgery and 3 days after surgery in the two groups can be used as evaluation indicators for clinical treatment effect and patient prognosis. |
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