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find Keyword "腹股沟" 140 results
  • CLINICAL RESEARCH OF LAPAROSCOPIC BUNDLED FASTIGIATED MESH IN REPAIRING INGUINAL HERNIA

    Objective To explore the method and effectiveness of laparoscopic bundled fastigiated mesh in repairing inguinal hernia. Methods Between January 2003 and December 2009, 1 215 patients (1 363 sides) with inguinal hernia were treated. There were 1 132 males (1 268 sides) and 83 females (95 sides), aged from 18 to 89 years (median, 58 years). The cases included 1 187 cases (1 329 sides) of primary hernia and 28 cases (34 sides) of recurrent hernia. There were indirect inguinal hernia in 728 cases (786 sides), direct inguinal hernia in 416 cases (499 sides), femoral hernia in 43 cases (45 sides), and unusual hernia in 28 cases (33 sides). According to the hernia classification criteria, there were 31 cases (38 sides) in type I, 683 cases (754 sides) of type II, 403 cases (452 sides) of type III, and 98 cases (119 sides) of type IV. The disease duration was 1 to 9 days with an average of 3.8 days. To repair the hernia, the bundled fastigiated mesh was patched through the internal inguinal ring and fixed on the internal inguinal fascia by three-point fixation. The mesh would be wrapped in the peritoneum by purse-string suture. Results The surgeries were performd successfully. The operative time ranged from 18-32 minutes (mean, 22 minutes). Postoperative tractional pain in the inguinal region occurred in 19 cases (21 sides), acute uroschesis in 8 cases, and far-end hernial sac effusion in 2 cases (2 sides); all were cured after symptomatic treatment. All incisions healed by first intention, and no complications of fever, infection, or hematoma occurred. A total of 1 095 cases (1 182 sides) were followed up 1 to 7 years (median, 3 years and 9 months). Five patients died of medical illnesses at 1-3 years after operation. Three cases recurred and then were cured by a second surgery. No intestinal adhesion or obstruction occurred. Conclusion The bundled fastigiated mesh in laparoscopic inguinal hernia repair has the advantages of minimal invasiveness, easy-to-operate, less complications, and lower recurrence rate.

    Release date:2016-08-31 05:45 Export PDF Favorites Scan
  • Experience of Treatment of Inguinal Groove Incarcerated Hernia with Small Intestine Necrosis by Plug Mesh Tension-Free Hernioplasty (Report of 21 Cases)

    目的评价应用疝环充填式无张力疝修补术治疗腹股沟嵌顿疝并发小肠坏死的手术效果。方法对于我院2001年5月至2009年5月期间收治的21例腹股沟嵌顿疝并发小肠坏死患者应用疝环充填式无张力疝修补术给予一期修补,先行坏死肠管切除,后置入网塞。结果无手术死亡病例,1例患者发生切口感染,经换药后治愈。平均住院时间65 d。全部患者随访6个月至8年,平均51个月,未见复发。结论 疝环充填式无张力疝修补具有创伤小、安全及患者恢复快的优点,对于腹股沟嵌顿疝并发小肠坏死可以行一期修补,临床效果满意。

    Release date:2016-09-08 10:41 Export PDF Favorites Scan
  • 老年复发性腹股沟疝的修复

    Release date:2016-09-01 09:29 Export PDF Favorites Scan
  • ADVANCES IN CLINICAL APPLICATION OF HERNIOPLASTY BY HIGH MOLECULAR MATERIAL

    Objective To study the advances in clinical application of hernioplasty by high molecular material. Methods The literature in the recent years on the advances of hernioplasty by high molecular material was reviewed. Results At present time many operative techniques of hernioplasty by high molecular material have been developed. The representative techniques were ①Rives-Stoppa′s mesh inlay hernioplasty; ②Lichtenstein′s tesion-free herniorrhaphy; ③mesh plug hernioplasty; ④Gilbert′s sutureless hernioplasty; ⑤laparoscopic inguinal hernioplasty. The reparing high molecular material was divided into absorbable and unabsorbable material, the former included polyglycolic-acid and polyglaction, the later consists of polypropylene polyester and expanded polytetrafluoroethylene.Conclusion The clinical application of henioplasty by high molecular material is increasing. According to the hernia type and patient condition, excellent outcome will be achieved by the application of proper repairing method and repair material.

    Release date:2016-09-08 01:59 Export PDF Favorites Scan
  • Clinical Observation of 168 Cases of Improvement of Inguinal Hernia Surgery Using Regional Block Anesthesia

    目的 分析改良区域阻滞麻醉法在腹股沟疝手术中的临床应用价值。方法 对2003年12月至2008年12月期间我院收治的168例腹股沟疝患者应用区域阻滞麻醉,对术中疼痛、肌松程度、手术时间、术后并发症、住院时间和住院费用方面进行临床观察。结果 所有患者麻醉效果满意,肌肉松弛,解剖层次清楚,除5例在牵扯精索时有轻微酸痛外,余无任何不适,术后无特殊并发症。平均手术时间40 min(包括麻醉),平均住院9 d,普通疝修补术平均费用1 480元,无张力疝修补术平均费用3 265元。结论 改良区域阻滞麻醉下行腹股沟疝手术麻醉效果满意、安全性高、简单易行、经济实惠,可作为各种腹股沟疝手术的麻醉方法,更适合在基层医院应用。

    Release date:2016-09-08 10:50 Export PDF Favorites Scan
  • Laparoscopic Transabdominal Preperitoneal Versus Totally Extraperitoneal Approach of Inguinal Hernia Repair:A Meta Analysis

    Objective To evaluate the clinical application of the different operative approaches of the laparoscopicrepair of inguinal hernia and provide a more rational and scientific choice for the surgeon. Methods The strict inclusion and exclusion criteria were set up. All the randomized controlled trials (RCT) about laparoscopic transabdominal preperi-toneal (TAPP) and totally extraperitoneal (TEP) approaches of laparoscopic inguinal hernia repair were collected. Meta an-alysis was performed according to the recommendation by the Cochrane handbook. Results Seven RCTs including 552 patients were analyzed, who were divided into TAPP group (n=302) and TEP group (n=250). Compared with TAPP group, there were no significant differences of the operation time〔WMD=8.49, 95% CI (-1.37, 18.35), P=0.09〕, postoperative hospitalization〔SMD=0.11, 95% CI (-0.12, 0.34), P=0.34〕, postoperative recurrence rate 〔OR=1.37, 95% CI (0.36, 5.20), P=0.64〕, and complications (incision infection, urinary retention) 〔Incision infection:OR=4.27, 95% CI (0.85, 21.57), P=0.08;Urinary retention:OR=0.61, 95% CI (0.21, 1.78), P=0.36〕in the TEP group. But the postoperative 24 h pain in the TEP group was significantly milder than that in the TAPP group 〔WMD=0.72, 95% CI (0.58, 0.87), P<0.000 01〕. Conclusions The currently available evidence shows that postoperative 24 h pain in the TEP group is more milder than that in the TAPP group. The time of the operation, postoperative hospitalization, postoperative recurrence, and complications are no significant differences between TAPP group and TEP group. Large-scale, high-quality RCTs are still needed to confirm or refuse the available evidence.

    Release date:2016-09-08 10:34 Export PDF Favorites Scan
  • 腹股沟富于细胞性血管纤维瘤1例报道并文献复习

    目的 探讨富于细胞性血管纤维瘤(cellular angiofibroma,CAF)的影像学表现、病理特征、临床诊断、鉴别诊断以及治疗和预后。方法 报道1例腹股沟区CAF的临床表现、病理特征及治疗情况,并结合国内外相关文献报道的142例病例资料进行分析。 结果 本例65岁男性患者,因发现左侧腹股沟区肿块5年且逐渐长大而入院行手术完整切除左侧腹股沟区肿物,肿物约7 cm×3 cm×5 cm大,质地较韧,边界清晰,术后病理学检查见肿物由大量短梭形细胞和小到中等大的血管组成,边界清晰,可见纤维性包膜。免疫组织化学示雌激素受体(部分 +)、平滑肌肌动蛋白(血管 +)、CD34(+)及CD117(+),Sox-10、S-100、Dog-1、结蛋白、P16、CDK4、mdm2、上皮膜抗原、孕激素受体、视网膜母细胞肿瘤抑制蛋白及神经营养因子络氨酸激酶均为(–)。最终诊断为CAF,术后随访3个月肿瘤无复发。复习国内外文献报道的142例CAF患者资料,肿瘤主要位于外阴(74例)和阴囊-腹股沟区(47例),21例位于其他部位,均接受手术治疗。CAF通常表现为触及无痛性肿块,肿瘤大体呈圆形、卵圆形或分叶状,镜下可见瘤体由大量梭形或短梭形细胞及丰富中小血管组成,间质胶原纤维化并伴有炎性细胞浸润,免疫组织化学特征表现为波形蛋白、CD34及平滑肌肌动蛋白阳性,部分表达雌激素受体和孕激素受体,结蛋白及S-100呈阴性。治疗以完整切除肿瘤为主,预后良好。 结论 CAF为好发于两性生殖道远端的良性间叶性肿瘤,治疗以手术完整切除肿瘤为主,预后良好,术后需严密随访。

    Release date:2023-11-24 10:51 Export PDF Favorites Scan
  • Prevention and Treatment on Operative Complications of Irreducible Hernia and Inguinal Strangulated Hernia

    目的 探讨腹股沟难复疝和嵌顿疝手术并发症的防治。方法 回顾性分析笔者所在医院2005年1月至2012年1月期间收治的69例腹股沟疝行手术治疗患者的临床资料。难复疝37例,嵌顿疝32例(其中Richter疝3例、Littre疝1例、Maydl疝3例 、Amyand疝1例)。结果 69例患者均行手术治疗,其中行单纯疝囊高位结扎术3例,Shouldice法修补术10例,Lichtenstein术7例,无张力充填式疝修补术43例,Modified Kugel补片修补术6例。术后1例死亡。术后早期并发症13例,包括肠管损伤3例、腹股沟神经损伤4例、血清肿4例、切口感染2例; 晚期并发症9例,包括慢性疼痛2例、缺血性睾丸炎1例及疝复发6例。结论 术前对于复杂性嵌顿疝和滑动疝经验不足,术后对于并发症的预防性处理不足是导致术中、术后并发症的主要原因。正确认识复杂性嵌顿疝和滑动疝,以及正确选择网片可减少难复疝和嵌顿疝手术并发症的发生。

    Release date:2016-09-08 10:24 Export PDF Favorites Scan
  • Experience of Inguingal Hernina Repair by Using Auto Herinal Sac andRegional Block Anesthesia( Reports of 36 Cases)

    目的 探讨局部麻醉下行自体疝囊植入法修补腹股沟疝的方法和治疗体会。方法 对36例腹股沟疝患者的临床资料进行回顾性分析,单一采用利多卡因作腹股沟区域阻滞麻醉,并改进利用自体疝囊植入充填封闭内环部及腹股沟管后壁的缺损与裂隙,然后进行常规方法修补缝合。结果 本组36例患者麻醉与手术效果皆满意,平均麻醉时间5min,平均手术时间40min,术中均未再注射止痛药物。患者术后早期切口有饱满、夯实感,疼痛症状较传统手术轻。无伤口瘀血、感染、阴囊血肿或尿潴留等并发症发生。术后6h即可进食,2~5d可下床活动,平均住院时间7d,住院费用较硬膜外麻醉减少20%~30%。经随访1~5年,平均随访3年,无再复发。结论 局部区域阻滞麻醉安全性高,并完全能满足手术需要;而自体疝囊组织为“天然补片”,植入后可充分加强内环部及腹股沟管后壁的强度,愈合后形成较为坚固的纤维组织壁,最大程度地防止疝的形成与复发。麻醉与手术操作相对简单,费用低廉,便于基层医院开展。

    Release date:2016-09-08 10:38 Export PDF Favorites Scan
  • 阴茎癌髂腹股沟淋巴结清扫术的护理

    【摘要】 目的 总结阴茎癌髂腹股沟淋巴结清扫术的护理方法。 方法 2007年5月-2009年5月,对17例阴茎鳞状细胞癌行髂腹股沟淋巴结清扫术患者术前、术后予以精心护理,不仅使患者以积极的心态配合治疗,而且最大程度的控制和减少了并发症的发生。 结果 17例患者均恢复良好。 结论 正确的专科护理对促进阴茎癌患者的康复有明显的作用。

    Release date:2016-09-08 09:25 Export PDF Favorites Scan
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