再论腹壁的力学原理——各向异性的临床与思考  

Further discussion on the mechanical principle of abdominal wall—clinical and thinking of anisotropy

作　　者：陈双[1] 江志鹏[1] CHEN Shuang;JIANG Zhi-peng(Department of Gastrointestinal and Hernia Surgery,the Sixth Affiliated Hospital of Sun Yatsen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院胃肠、疝与腹壁外科,广东广州510065

出　　处：《中国实用外科杂志》2022年第2期159-162,共4页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金面上项目(No.81973858)。

摘　　要：腹壁的物理学特性包括刚性、顺应性、各向异性等,其与腹壁功能的实现及疝外科的手术原理、手术效果息息相关。其中,各向异性指在力的作用下腹壁在不同轴向,尤其是横向(左右两侧)与纵向(头尾两侧)表现出的刚性和顺应性的差异。各向异性与腹壁肌、腹壁筋膜系统、腹白线等结构的机械特性有关。腹壁的各向异性可解释许多腹壁外科的临床问题,包括Keyhole手术为何容易复发、为何要尽量保护腹白线、腹壁缺损应如何关闭等。因此,腹壁外科无论是术式选择还是修复材料设计都应从腹壁的机械特性角度去考量。外科医生也需要增进这方面的了解以更好地理解、运用和创新腹壁外科的技术。The physical characteristics of the abdominal wall,including stiffness, compliance, anisotropy, etc., are closely related to the realization of abdominal wall function, the principle and the effect of surgery. Among them, anisotropy refers to the difference in stiffness and compliance of the abdominal wall in different axial directions under the action of force, especially the transverse and the craniocaudal direction.This difference is related to the mechanical properties of abdominal wall muscles, fascia system, linea alba, etc. The anisotropy explains many clinical problems, including why the Keyhole procedure is prone to recurrence, why the linea alba should be protected, and how to close the abdominal wall defect. Therefore, in abdominal wall surgery, both surgical selection and repaired material design should be considered from the perspective of mechanical characteristics. Surgeons also need to improve their understanding in order to better understand, use and innovate abdominal wall surgery techniques.

关 键 词：腹壁 机械特性 各向异性 腹白线 腹壁肌 

分 类 号：R6[医药卫生—外科学]