完全腹膜化腹腔内置网片修补兔腹股沟疝的研究  

The study of total peritoneum intraperitoneal onlay mesh repairing inguinal hernia on rabbits

作　　者：杨喜光[1] 向国安[2] 陈小勋[1] 张达[3] 陈开运[2] 

机构地区：[1]贵港市人民医院胃肠外科,广西537100 [2]广东省第二人民医院普通外科 [3]西安市中心医院普通外科

出　　处：《中华实验外科杂志》2014年第12期2756-2757,共2页Chinese Journal of Experimental Surgery

基　　金：吴阶平医学基金会临床科研基金资助项目（320675009106）;广东省医学科学基金资助项目（A2009132）;西安市科技计划项目（SF13245）

摘　　要：目的 探讨腹腔镜脐正中襞覆盖网片修补兔腹股沟疝手术的安全性和可行性.方法 将健康新西兰雄兔64只随机分成两组,每组32只,一组行完全腹膜化腹腔内置网片修补术（TPIPOM）;另一组行腹腔镜腹腔内网片植入术（IPOM）,两组于术后第7、15、30、60天各取8只镜下测量两组兔内环口破裂瞬间所能承受的抗压值;切除TPIPOM修补区域,组织切片观察脐正中襞、网片与腹膜组织融合情况.结果 研究期内兔无死亡.术后IPOM组发现肠粘连6例,TPIPOM组未发现肠粘连,差异有统计学意义（P＜0.05）.两组兔均未发现肠穿孔、肠坏死、疝复发等并发症.TPIPOM组抗压值在术后第7、15、30、60天均优于IPOM组,差异有统计学意义（P＜0.05）.脐正中襞、网片与腹膜融合良好,未出现萎缩.组织切片观察：TPIPOM修补区域愈合符合慢性非细菌性炎症修复过程.结论 腹腔镜脐正中襞覆盖网片修补兔腹股沟疝手术安全、可靠.Objective To invcstigate the security of 1 aparoscopic inguinal hernia repair with median umbilicus fold overlap mesh on rabbits,and provide basic theory for clinical application of total peritoneum intraperitoneal onlay mesh （TPIPOM）.Methods 64 healthy New-Zealand male rabbits were divided into two teams randomly.There were 32 rabbits in each team.TPIPOM was operated in one team,and IPOM was operated in the other team.8 rabbits in each teams were observated under laparoscope in the 7th,15th,30th,60th days after operation.The anti-tension strengthes when hernial inner ring cracking were measured in both teams.Repair region of TPIPOM were resected.The syzygial status of median umbilical fold,mesh and peritoneum tissue were observed by histological section.Results None rabbits died during the research.6 cases of ankylenteron in the IPOM team have been discovered,but none in TPIPOM team.The defferences have statistical significance （P 〈 0.05）.None of intestinal perforation,intestinal necrosis,hernia relapses and ect.complications have been discovered in the both teams.The anti-tension strengthes of rabbits in both teams in the postoperative 7th,15th,30th,60th days respectively.The defferences have statistical significance （P 〈 0.05）.The syzygial status of median umbilicus fold,mesh and peritoneum tissue are fine and have no atrophy.Histological section observation：the agglutination of repair region in TPIPOM consistents with reparative process of chronic nonbacterial inflammation.Conclusion The operation of 1 aparoscopic inguinal hernia repair with median umbilicus fold overlap mesh on New-Zealand rabbits is reliable.

关 键 词：腹腔镜 脐正中襞 动物实验 腹股沟疝 疝模型 完全腹膜化腹腔内置网片修补术 腹腔内网片植入术 

分 类 号：R656.2[医药卫生—外科学]