腰疝的诊断与外科治疗

Diagnosis and Surgical Treatment of Lumbar Hernia

目的:探讨腰疝的临床表现特点、诊断方法、治疗经验和临床分型的可行性。方法:对6年间经治的12例腰疝的诊断、治疗及解剖特点等进行回顾性总结和分析。结果:临床症状有腰背痛、腰部肿块、恶心、呕吐,合并肠梗阻时有腹胀、腹痛、停止排便排气。腰上三角疝12例,1例合并腰下三角疝。疝内容物为脂肪块、结肠或嵌顿坏死小肠。1例拒绝手术,8例病人利用邻近组织缝合修补,3例使用人工合成补片修补。随访未见复发。结论:腰疝是一种临床少见的腹外疝,临床表现和体征是诊断腰疝的关键。外科手术是治疗腰疝的有效手段。

Objective To study the diagnosis and treatment of lumbar hernia,to explore the possibility of clinical categorization Methods Twelve cases of lumber hernia were studied by clinical observation retrospectively from July 1997 to July 2003.Nine patients were male and three were female,with an average age of 58.5(47～78 years).Results The clinical manifestation of lumbar hernia included lumbar pain,nausea,and vomiting.In case of gut incarcerated,bowel obstruction subsequently developed.The typical sign revealed a painful flank bulging in the superior or inferior triangle.Twelve patients had their lumbar hernia in superior lumbar triangle;one of them had his hernia in inferior lumbar triangle simultaneously.Eleven out of twelve cases could be repaired successfully. Conclusion The clinical symptoms and signs usually make the diagnosis likely.CT scanning is helpful for diagnosing lumbar hernia.Excision of the herniac sac and high ligation followed by repairing with surrounding tissue or by prosthetic material.may give a satisfactory result.