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《探討無(wú)張力疝修補(bǔ)手術(shù)對(duì)腹股溝疝的臨床治療》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在工程資料-天天文庫(kù)。
1、腹疝是腹腔內(nèi)臟器、安排經(jīng)裂孔區(qū)、空隙進(jìn)入其他區(qū)域的—種病癥,以腹股溝嵌頓性斜疝(incarceratedindirectinguinalhernia,IIIH)多見(jiàn)。這些年，無(wú)張力疝修補(bǔ)術(shù)(opentension-freehernioptasty,OTFH)在腹股溝疝修補(bǔ)術(shù)中得到廣泛使用，OTFH可以有些糾正傳統(tǒng)修補(bǔ)術(shù)(conventionalinguinalherniorrhaphy,Ventralherniaisabdominalorgans,arrangedbyanillnesshiatusarea,gapsandint
2、ootherregions,withinguinalstrangulatedhernia(incarceratedindirectInguinalHernia,IIIH).Theseyears,tension-freeherniarepair(opentension-freehernioptasty,OTFH)arewidelyusedintherepairofinguinalhernia,OTFHcouldbesomecorrecttraditionalrepair(conventionalinguinalherniorrh
3、aphy,CIH)缺陷，在保證腹股溝區(qū)正常的解剖布局條件下，下降復(fù)發(fā)率。本文回憶性剖析了運(yùn)用OTFH傳統(tǒng)修補(bǔ)術(shù)醫(yī)治IIIH的臨床特色，現(xiàn)報(bào)導(dǎo)如下。CIH)defects,theanatomyofinguinalregionlayoutnormalconditions,decreaserecurrencerate.ThispaperanalyzedtheclinicalcharacteristicsofmemoriesoftheuseofOTFHtraditionalrepairtotreatIIIH,reportasfollo
4、wsnow.1材料與辦法1materialsandmethods1.1通常材料1.1usuallymaterials挑選目標(biāo)為自2007年2月到2012年7月間在我院選用南通富麗康補(bǔ)片經(jīng)過(guò)腹股溝斜疝、直疝手術(shù)中的患者76例，年紀(jì)22?72歲，均勻年紀(jì)(46?0±1?5)歲，病程10天?30年，均勻(3.44±0.5年)。76例中雙側(cè)疝10例，其間有2例為復(fù)發(fā)疝；單側(cè)66例，其間復(fù)發(fā)疝I2例。隨機(jī)均勻分為兩組?調(diào)查組38例(包括一切復(fù)發(fā)疝)，行充填式無(wú)張力疝修補(bǔ)術(shù);對(duì)照組38例，行平片無(wú)張力疝修補(bǔ)術(shù)。兩組患者在性別、年紀(jì)、工作、
5、病況、發(fā)病時(shí)刻上，經(jīng)計(jì)算學(xué)查驗(yàn)比擬區(qū)別無(wú)顯著性(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手術(shù)辦法1.1operationmethods首要對(duì)兩組患者均選用硬膜外麻醉或腰麻。切斷挑選同傳統(tǒng)腹股溝疝修補(bǔ)術(shù)：沿腹外斜肌纖維方向切開(kāi)，將腹外斜肌腱膜從其下方的腹內(nèi)斜肌淺面充沛游離，外側(cè)達(dá)腹股溝韌帶，內(nèi)側(cè)聯(lián)合腱，即榜首空隙，對(duì)骼腹股溝神經(jīng)
8、及骼腹下神經(jīng)加以維護(hù)。游離精索，精索下端游離至暴露恥骨結(jié)節(jié)2cm，上端游離疝囊至腹膜外脂肪處。查看疝環(huán)內(nèi)口巨細(xì)及腹股溝管后壁狀況，斷定疝的結(jié)尾分型。對(duì)照組38例患者將疝行高位結(jié)扎，縫合提睪肌后，將平片置入精索后，精索由補(bǔ)片上端開(kāi)口經(jīng)過(guò)，把補(bǔ)片的下端圓角縫合固定在距恥骨緣1.5
