回盲肠Treves皱襞的解剖学组织学观察及其临床意义

Anatomical and histological observation of ileocecal Treves fold and its clinical significance

对2011年12月至2017年8月在大连大学附属中山医院急腹症外科行肠道手术的56例成年患者,术中观察回盲肠Treves皱襞(回盲皱襞)的解剖学结构,取15例患者的15条回盲皱襞组织行组织学观察。男、女性患者(34和22例)回盲皱襞平均长度分别为(5.56±0.18)和(5.22±0.05)cm,宽度为(1.82±0.04)和(1.78±0.06)am,厚度均为(0.18±0.02)cm。HE及verhoeff染色镜检见回盲皱襞主要由弹力纤维、胶原纤维及少许平滑肌构成;有明确的血管供应。术中30例应用自身回盲皱襞进行修补,其中覆盖缝合固定于阑尾切除残端26例、结肠憩室穿孔修补残端3例、Meckels憩室穿孔修补残端1例,术后近、远期无粪瘘、肠梗阻及肠套叠等并发症发生。回盲皱襞位置恒定,可为回肠末端标志;血运好,适用于回盲部手术的修复和重建。

From December 2011 to August 2017,56 patients with acute abdomen surgery were treated in Affiliated Zhongshan Hospital of Dalian University.The anatomical structure of ileocecal Treves folds was observed during operation,and 15 samples of Treves folds were taken for histological examination.The mean length of the fold was (5.56±0.18)cm for males and (5.22±0.05)cm for female,the width was (1.82± 0.04) cm for males and (1.78 ± 0.06) cm for females;the thickness was (0.18 ± 0.02) cm.HE and verhoeff staining showed that Treves fold was mainly composed of elastic fiber,collagen fiber and smooth muscle with abundant blood supply.Thirty patients were repaired with their own Treves folds,including the fixation with overlay suture to the stump of appendectomy in 26 cases,repairing for perforation of colonic diverticulum in 3 case,and repairing for perforation of colonic diverticulum in 1 case.There were no complications such as fecal fistula,intestinal obstruction and intussusception after operation.The Treves fold has a constant location,which can be used as a clear sign of ileal terminal.It has abundant blood supply,and is suitable for the repair and reconstruction in ileocecal operation.