脐侧襞加强术对兔腹股沟区强度的影响  

The effects of lateral umbilical augmentation surgery on rabbit inguinal region intensity

作　　者：张达[1] 刘东博[1] 谭云鹤[1] 杨喜光[2] 向国安[3] 

机构地区：[1]西安市中心医院普外科,西安710003 [2]广西自治区贵港市人民医院胃肠外科 [3]广东省第二人民医院普通外科

出　　处：《陕西医学杂志》2016年第8期939-941,共3页Shaanxi Medical Journal

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

摘　　要：目的:利用兔实验证明腹股沟疝修补、脐侧襞加强术后的腹股沟区强度高于单纯腹股沟疝修补术后强度。方法:将64只新西兰雄兔随机分为A、B两组,每组32只。A组在腹腔镜下行单侧腹股沟疝疝囊高位结扎术;B组在腹腔镜下行单侧腹股沟疝疝囊高位结扎、脐侧襞韧带加强术。术后1、2、3、7d观察B组兔脐侧襞韧带与腹壁固定缝合后相互融合情况,同时对A、B两组进行抗张强度测定并进行统计学分析,测定后取脐侧襞韧带与腹壁融合处组织进行病理学观察。结果:研究期内兔无死亡。术后B组兔的脐侧襞韧带与腹壁融合良好。结果:B组的腹股沟区平均抗张力强度较A组强,差异有统计学意义(P<0.05)。B组术后的病理组织细胞学可见:脐侧襞韧带与壁腹膜层间炎症细胞数较多,出现有血管增生、肉芽肿形成、最终有大量的胶原纤维形成,组织瘢痕化,炎症细胞数明显减少,两层组织间纤维组织交互生长。结论:脐侧襞韧带加强术可提高腹股沟区抗张力强度,为其治疗小儿腹股沟疝奠定理论基础。Objective：To prove that the tensile strength of inguinal area of laparoscopic high ligation of hernia sac with median umbilical fold enhancement was more superior through animal experiment.Methods：64male New Zealand rabbits were randomly distributed into A、B group.Group A were given a unilateral laparoscopic high ligation of hernia sac only;groups B were given laparoscopic high ligation of hernia sac with median umbilical fold enhancement.All 2groups were observed on day 1,2,3and 7for any surgical complications.laparoscopic approaches were performed that the fusion of median umbilical fold and peritoneum and possible adhesion of B were investigated,test the tensile strength of inguinal area,a biopsy on tissue from fusion area were performed,and the results were statistically analyzed.Results：All animal survived during experiment.Group B had superior mean tensile strength than group A on 7d,15 d,30d,60 d,with statistical significance（P〈0.05）.Pathology observation spot post surgery：massive inflammation cells and low secretion of collagen fiber,vascular proliferation and granuloma,reduction of inflammatory,massive collagen fiber,tissue cicatrix and significant reduction of inflammatory cells.Conclusion：The results of tensile strength of laparoscopic high ligation of hernia sac with median umbilical fold enhancement is guaranteed,make the theoretical basis to cure the hernia for children.

关 键 词：疝 腹股沟 腹腔镜 @脐侧襞加强术 动物 实验 

分 类 号：R657.8[医药卫生—外科学]