儿童盆腔肾滑动疝1例诊疗分析  

Diagnosis and treatment analysis of 1 case of pelvic kidney sliding hernia in children

作　　者：杨映然 王宁 吴学东 张杉杉 李娜 申伟 YANG Yingran;WANG Ning;WU Xuedong;ZHANG Shanshan;Li Na;SHEN Wei(Department of Pediatric Surgery,The First Affiliated Hospital of Dali University,Dali,Yunnan 671000,China)

机构地区：[1]大理大学第一附属医院小儿外科,云南大理671000

出　　处：《医药前沿》2025年第5期52-53,57,共3页Journal of Frontiers of Medicine

摘　　要：目的探讨1例儿童盆腔肾滑动疝的临床特点及诊疗难点,为临床诊疗工作提供参考。方法报告1例盆腔肾滑动疝患儿的临床资料,并对其临床特点进行回顾性分析。结果患儿女,10岁,因发现右侧腹股沟区可复性包块1个月入院。术前诊断:右侧腹股沟斜疝,右侧盆腔肾。全身麻醉下行腹腔镜辅助腹股沟斜疝修补术。术中明确诊断:右侧腹股沟滑动疝,采用Bevan法弧形切开卵巢被覆腹膜,适当游离卵巢和肾脏下极,缝合近内环口的腹膜缘,形成完整的疝囊壁。疝环处缝合1周,高位结扎疝囊壁。术后随访3个月未见疝复发,双侧肾盂无扩张及积水。结论盆腔肾能诱发滑动疝。分离疝囊和脏器被覆的腹膜,再修补成完整的疝囊壁并予以高位结扎是治疗滑动疝的基本手术策略。盆腔肾是否需要复位要根据是否出现并发症而确定。Objective To explore the clinical characteristics and difficulties of diagnosis and treatment of 1 case of pelvic kidney sliding hernia in children,and to provide reference for clinical diagnosis and treatment.Methods The clinical data of a child with pelvic kidney sliding hernia were reported,and the clinical characteristics were retrospectively analyzed.Results The 10-year-old female child was admitted to the hospital due to the discovery of a reducible mass in the right inguinal region for 1 month.The preoperative diagnosis was right indirect inguinal hernia and right pelvic kidney.Laparoscopic-assisted repair of right indirect inguinal hernia was performed under general anesthesia.The intraoperative diagnosis was right inguinal sliding hernia,the peritoneum covering the ovary was incised in an arc shape using the Bevan method,the ovary and the lower pole of the kidney were appropriately dissected,and the peritoneal margin near the internal ring was sutured to form a complete hernial sac wall.The hernial ring was sutured for 1 week,and the hernial sac wall was ligated at a high position.No hernia recurrence was observed during the 3-month follow-up,and there was no dilation or hydrops in bilateral renal pelvis.Conclusions Pelvic kidney can induce sliding hernia.The basic surgical strategy for treating sliding hernia is to separate the peritoneum covering the hernial sac and organs,then repair it into a complete hernial sac wall and ligate it at a high position.Whether the pelvic kidney needs to be reset should be determined according to the presence of complications.

关 键 词：滑动疝 盆腔肾 儿童 异位肾盂 复位 诊疗 

分 类 号：R692[医药卫生—泌尿科学]