无张力疝修补术的现代解剖学基础及其合理性分析

Analysis of basis in modern anatomy and rational natue for the tension-free hernioplasty

目的应用现代外科解剖学技术、观点,探讨无张力疝修补术治疗腹股沟疝的科学性、合理性。方法(1)解剖40侧成人尸体标本,对腹股沟区的局部解剖结构进行研究。(2)2002年9月～2007年12月采用美国巴德公司的疝环充填物及网状补片对290例腹股沟疝患者施行的无张力疝修补术进行了回顾性总结分析。结果(1)腹股沟区的薄弱结构和腹横筋膜的缺损是疝发生的根本原因,耻骨肌孔和髂耻束在疝修补术中具有重要的解剖学意义。(2)无张力疝修补术方法简便、创伤小、术后疼痛轻、康复快、复发率低。结论无张力疝修补术的施行符合人体腹股沟区的解剖结构特点,能纠正发生疝的病理缺陷,具有科学性、合理性。

Objective To explore the scientific rational nature for the tension-free hernioplasty. Methods （ 1 ） Study of inguinal anatomy in 40 corpses. （2） Tension-free hernioplasty in 290 patients performed in our hospitals from September 2002 to December 2007 were retrospectively reviewed. Results （1） Frail inguinal structure and defective fascia transversalis were causes of hernia. Myopectineal orifice and iliopubic tract had important significance. （2） Tension-free hernioplasty had good points, such as easier surgical performance, less postoperative pain, quicker recovery, fewer complications and lower rate of recurrence. Conclusion The tension-free hernioplasty has scientific rational nature in anatomy and pathology.