腰疝29例临床分析  

Clinical analysis of lumbar hernia in 29 cases

作　　者：王琛 黄瀚章 杜舟[1] 周锋[1] 阮小蛟[1] 韩少良[1] WANG Chen;HUANG Hanzhang;DU Zhou;ZHOU Feng;RUAN Xiaojiao;HAN Shaoliang(Department of General Surgery,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou,325015)

机构地区：[1]温州医科大学附属第一医院胃肠外科,浙江温州325015

出　　处：《温州医科大学学报》2018年第9期691-693,共3页Journal of Wenzhou Medical University

摘　　要：目的:探讨腰疝的临床特征、诊断和治疗方法。方法:对1990年1月至2017年12月温州医科大学附属第一医院收治的29例腰疝患者的临床资料进行回顾性分析。结果:男13例,女16例;左侧18例,右侧10例,双侧1例;可复性疝28例及嵌顿疝1例。腰疝自腰上三角突出27例,自腰下三角突出2例。最常见的临床表现是腰背部可复性肿块28例,腰背部疼痛不适21例,合并不全肠梗阻出现腹胀、腹痛、恶心、呕吐2例。术前B超正确诊断23例(占79.3%),CT扫描正确诊断25例(占86.2%)。保守治疗4例,其他25例实施手术治疗。手术方式包括腰疝口缝合1例,补片修补23例及腹腔镜补片修补1例。25例手术患者术后均恢复较好,临床症状消失;随访中1例患者术后2个月复发(腰疝口缝合),后行补片修补术治愈。结论:腰疝的诊断依据其临床表现、B超及CT检查所见,治疗首选补片无张力修补。Objective： To study the clinical manifestation, diagnosis and treatment of lumbar hernia. Methods： The clinical data of 29 patients with lumbar hernia who were admitted to the First Affiliated Hospital of Wenzhou Medical University from January 1990 to December 2017 were analyzed retrospectively. Results： Among 13 males and 16 females, there wer 18 left, 10 right and 1 bilateral hernias. Reversible hernias were in 28 cases and incarcerated hernia in 1 cases. There were 27 lumbar hernias protruded from the upper lumbar triangle （Grynfelt’s triangle）, 2 cases from the lower lumbar triangle （Petit’s triangle）. The most common clinical manifestations were reversible mass of the back, which was observed in 28 cases, and 21 cases were associated with back pain, while 2 cases associated with incomplete intestinal obstruction such as abdominal distension, abdominal pain, nausea and vomiting. The correct rate of preoperative ultrasound diagnosis was 79.3% （23/29 cases）, and the correct rate of CT scanning diagnosis before operation was 86.2% （25/29 cases）. In this group, 4 cases were treated conservatively and 25 cases were treated surgically. The surgical procedures included simple suture in 1 case, mesh repair in 23 cases, and laparoscopic mash repair in 1 case. All the 25 patients well recovered after operation, with their clinical symptoms disappeared. During the follow-up period, 1 case recurred 2 months after operation, and was cured by mesh repair operation again. Conclusion： The diagnosis of lumbar hernia is based on its clinical manifestations, B ultrasound and CT findings, and the first choice of treatment is tension-free repair with mesh.

关 键 词：腰疝 腰上三角 腰下三角 诊断 手术 

分 类 号：R604[医药卫生—外科学] R605[医药卫生—临床医学]