Abstract: Objective To investigate whether local thickening of inguinal hernia sac is related to bacterial infection. Methods From June 2015 to December 2016, 68 patients diagnosed as inguinal hernia in the Sixth Affiliated Hospital of sun Yat-sen University were selected. According to whether the hernia sac was thickened or not, the hernia sac was divided into thickened group and smooth group. The tissue structure composition and inflammatory cell count of the two groups were observed and compared, and the presence of bacterial DNA was detected by real-time fluorescence quantitative PCR. Results The incidence of internal lateral thickening of the hernia sac was 66.1% （37/68）, which was related to the course of disease （disease course <1 y 39.1%,1 y~5 y 46.1%,>5 y 84.2%）, previous incarceration （75% vs. 45.8%） and adhesion （95% vs. 37.5%）. Microscopic observation of the thickened hernia sac showed thickened fibrous connective tissue with more inflammatory cell infiltration（Neutrophils 15.2±2.3 vs. 2.5±0.7, lymphocytes 35.3±1.9 vs. 12.8±1.4, plasma cells 2.6±0.6 vs. 1.5±0.4, a total of 53.1±1.3 vs. 16.8±1.2, P < 0.05） and telangiectasia （67.6% vs. 25.8%, P<0.05）. DNA expression of e. coli was positive in 2 cases in the thickening group and 1 case in the smooth group. Conclusion Inguinal hernias, especially those with a long course and history of incarceration, may have local bacterial infection.

Key words: inguinal hernia, hernia sac, bacteria

摘要： 目的 探讨腹股沟疝疝囊局灶性增厚是否和细菌感染有关。方法 选取2015年6月至2016年12月于中山大学附属第六医院收治诊断为腹股沟疝患者68例（男56,女12）,腹腔镜直视下观察并记录疝囊形态。根据疝囊有无增厚分为增厚组（37例）和光滑组（31例）,观察比较两组标本的组织结构成分和炎性细胞计数,并用实时荧光定量PCR方法检测其中是否存在细菌DNA。结果 疝囊内侧面增厚的出现率为66.1%（37/68）,与病程（病程<1年39.1%,病程1~5年46.1%,病程>5年84.2%）和既往嵌顿史（75% vs. 45.8%）、粘连（95% vs. 37.5%）相关。显微镜下观察增厚疝囊组织可见纤维结缔组织增厚,并见较多炎性细胞浸润（中性粒细胞15.2±2.3 vs. 2.5±0.7,淋巴细胞35.3±1.9 vs. 12.8±1.4,浆细胞2.6±0.6 vs. 1.5±0.4,总计数53.1±1.3 vs. 16.8±1.2,P值均<0.05）,毛细血管扩张（67.6% vs. 25.8%,P<0.05）。增厚组发现2例大肠杆菌DNA表达阳性,光滑组1例阳性。结论 腹股沟疝,尤其是病程长、有嵌顿史的可能存在局部细菌感染。

关键词: 腹股沟疝, 疝囊, 细菌