资源描述:
《探讨无张力疝修补手术对腹股沟疝的临床治疗》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、腹疝是腹腔内脏器、安排经裂孔区、空隙进入其他区域的—种病症,以腹股沟嵌顿性斜疝(incarceratedindirectinguinalhernia,IIIH)多见。这些年,无张力疝修补术(opentension-freehernioptasty,OTFH)在腹股沟疝修补术中得到广泛使用,OTFH可以有些纠正传统修补术(conventionalinguinalherniorrhaphy,Ventralherniaisabdominalorgans,arrangedbyanillnesshiatusarea,gapsandint
2、ootherregions,withinguinalstrangulatedhernia(incarceratedindirectInguinalHernia,IIIH).Theseyears,tension-freeherniarepair(opentension-freehernioptasty,OTFH)arewidelyusedintherepairofinguinalhernia,OTFHcouldbesomecorrecttraditionalrepair(conventionalinguinalherniorrh
3、aphy,CIH)缺陷,在保证腹股沟区正常的解剖布局条件下,下降复发率。本文回忆性剖析了运用OTFH传统修补术医治IIIH的临床特色,现报导如下。CIH)defects,theanatomyofinguinalregionlayoutnormalconditions,decreaserecurrencerate.ThispaperanalyzedtheclinicalcharacteristicsofmemoriesoftheuseofOTFHtraditionalrepairtotreatIIIH,reportasfollo
4、wsnow.1材料与办法1materialsandmethods1.1通常材料1.1usuallymaterials挑选目标为自2007年2月到2012年7月间在我院选用南通富丽康补片经过腹股沟斜疝、直疝手术中的患者76例,年纪22〜72岁,均匀年纪(46・0±1・5)岁,病程10天〜30年,均匀(3.44±0.5年)。76例中双侧疝10例,其间有2例为复发疝;单侧66例,其间复发疝I2例。随机均匀分为两组•调查组38例(包括一切复发疝),行充填式无张力疝修补术;对照组38例,行平片无张力疝修补术。两组患者在性别、年纪、工作、
5、病况、发病时刻上,经计算学查验比拟区别无显著性(P>0.05)oChoosetargetfor2007Februaryto2012JulywithNantongFuliKangpatchafter76casesofpatientswithindirectinguinalhernia,herniaoperationinourhospital,aged22~72years,averageage(46±1.5)yearsold,30yearsdurationof10daysto,uniform(3.44±0.5years)・10ca
6、sesofbilateralherniain76cases,therewere2casesofrecurrenthernia;unilateralin66cases,L2casesduringrecurrenthernia.Uniformrandomdividedintotwogroups・Thestudygroup38cases(includingallrecurrenthernia),underwenttension-freeherniarepair;38casesinthecontrolgroup,underwentte
7、nsion-freehernioplasty.Thetwogroupsingender,age,illness,disease,worktime,thecomputationalidentificationcomparednosignificantdifference(P>0.05)•1.2手术办法1.1operationmethods首要对两组患者均选用硬膜外麻醉或腰麻。切断挑选同传统腹股沟疝修补术:沿腹外斜肌纤维方向切开,将腹外斜肌腱膜从其下方的腹内斜肌浅面充沛游离,外侧达腹股沟韧带,内侧联合腱,即榜首空隙,对骼腹股沟神经
8、及骼腹下神经加以维护。游离精索,精索下端游离至暴露耻骨结节2cm,上端游离疝囊至腹膜外脂肪处。查看疝环内口巨细及腹股沟管后壁状况,断定疝的结尾分型。对照组38例患者将疝行高位结扎,缝合提睾肌后,将平片置入精索后,精索由补片上端开口经过,把补片的下端圆角缝合固定在距耻骨缘1.5