疝入阴囊腹股沟直疝解剖学观察  

Anatomy observation of direct inguinal hernia extending into scrotum

作　　者：李英儒[1] 杨斌[1] 江志鹏[1] 赖东明[1] 张育超[1] 侯泽辉 吕泽坚[1] 陈双[1] 

机构地区：[1]中山大学孙逸仙纪念医院胃肠外科华南疝与腹壁外科培训中心,广东广州510120

出　　处：《中国实用外科杂志》2014年第11期1072-1074,共3页Chinese Journal of Practical Surgery

摘　　要：目的对腹股沟直疝和斜疝进入阴囊的病人进行解剖学观察,探讨直疝进入阴囊的机制。方法选取2011年6月至2013年5月于中山大学孙逸仙纪念医院就诊的48例腹股沟疝进入阴囊的病人,其中直疝3例、斜疝45例,分析精索与提睾肌、外环口的关系,比较直疝与斜疝疝囊的解剖学差异。结果 48例腹股沟疝无张力修补术均顺利完成。解剖学观察发现,直疝疝囊位于精索内下方,与精索容易分离,并经精索外筋膜与提睾肌之间进入阴囊,疝囊外面仅包绕薄弱的腹横筋膜。斜疝疝囊位于精索上方,与精索紧密粘连,经腹股沟管进入阴囊,外面包绕着精索内筋膜(腹横筋膜)及提睾肌。结论直疝疝囊长期对外环口进行冲击,导致外环口扩大,疝囊经精索外筋膜与提睾肌之间穿出外环口,精索位于疝囊的外上方。Objective To explore the mechanism that inguinal hernia descends into the scrotum by intraoperative observation. Methods From June 2011 to May 2013, a total of 48 patients whose sacs extend into scrotum admitted in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were involved in the observation. Among them, there were 3 direct and 45 indirect inguinal hernias. The relationship among the spermatic cord, eremaster and the outer ring. were analyzed. The differences between direct hernia sac and inguinal hemia sac were analyzed and compared. Results All the patients were operated successfully. Direct hernia sac located below the spermatic cord, and easily separated from the spermatic cord. The sac entered the scrotum between the fascia and outside cremaster spermatic cord, just surrounding the weak transverse fascia outside. Inguinal hernia sac was at the top of fine cord, and had tight adhesions with spermatic cord. The sac entered the scrotum through the inguinal canal, wrapped around the internal spermatic fascia （transverse fascia） and cremaster. Conclusion Because direct hernia sac always hits the outer ring long-term, the outer ring expanded. The sac breaks through the outer ring between external spermatic fascia and cremaster and the spermatic cord is located outside the top of it.

关 键 词：腹股沟疝 直疝 斜疝 阴囊 解剖学 

分 类 号：R6[医药卫生—外科学]