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青年腹股沟疝治疗中补片修补存在的问题及组织修补的价值

李航宇魏士博   

  1. 中国医科大学附属第四医院结直肠、疝外科,辽宁沈阳110032
  • 出版日期:2019-08-01 发布日期:2019-08-01

  • Online:2019-08-01 Published:2019-08-01

摘要:

世界卫生组织定义青年为14~25岁,而这一年龄段的腹股沟疝病人还处于身体发育期具有特殊的生理特点以及对生育功能保护的特殊需求,所以对其应谨慎选择修补方法。合成补片存在无法随生长发育一同延展、瘢痕过度增生压迫输精管以及远期侵袭等问题,生物补片也存在远期复发或局部膨隆的风险。对于青年人群,规范的组织修补手术可以良好地修补缺损,配合合理的围手术期管理,也可以最大限度地减轻术后早期张力过大所引起的不适感。同时,组织修补可以适应身体的生长,对生殖功能的影响相对较小,必要情况下也可以配合生物材料修补较大的缺损。术者熟练掌握技术后,组织修补的复发率是可以接受的。所以组织修补对于青年腹股沟疝病人的治疗,具有不可替代的价值。

关键词: 腹股沟疝, 青年, 组织修补, 补片修补, 无张力修补术

Abstract:

The problems of mesh repair and the value of tissue repair in the treatment of groin hernia in young people              LI Hang-yu, WEI Shi-bo. Department of Colorectum & Hernia Surgery, the Fourth Affilianted Hospital of China Medical University, Shenyang 110032, China
Corresponding author: LI Hang-yu, E-mail:li_hangyu@126.com
Abstract    The World Health Organization defines youth as 14 to 25 years old, and the inguinal hernia patients in this age group are still in the development stage of the body with special physiological characteristics and special needs for the protection of reproductive functions. Therefore, the repair method should be carefully selected for the special group and the principle of individualized treatment should be adhered to. The synthetic mesh has problems such as failure to extend with body growth, excessive scar hyperplasia compressing the spermaduct, and long-term invasion. The biological patch also has the risk of long-term recurrence or local bulging. For youth, standard tissue repair surgery can mending the defect well, with reasonable perioperative management, also can minimize the discomfort, which caused by excessive early postoperative tension. At the same time, tissue repair can adapt to the growth of the body, with relatively small impact on reproductive function, or can be combined with biological materials to repair large defects if necessary. After mastering tissue repair technology, the recurrence rate of tissue repair is acceptable. Therefore, tissue repair is of irreplaceable value in the treatment of young inguinal hernia patients.

Key words: inguinal hernia, youth, tissue repair, mesh repair, tension-free hernioplasty