CAJ | 학술논문

目的了解疝环充填式无张力疝修补术后网塞与成型补片的形态，探讨改进手术方法的必要性。方法应用B超对16例疝环充填式无张力疝修补术后病人网塞和成型补片进行观察并复习病历，评估手术方法对网塞和成型补片形态的影响及修补效果。结果 16例中有4例成型补片下端与耻骨缘重叠，12例未达到耻骨缘。对未达到耻骨缘的12例改变探头切入角度，发现8例成型补片下端呈高密度区增宽影，提示有折叠或卷曲，此高密度影与耻骨间还出现一低密度组织影间隙。未达到耻骨缘的12例中11例在手术中没有将成型补片下端与耻骨结节固定或曾剪短成型补片。结论施行疝环充填式无张力疝修补术时，成型补片的处理应视术中情况把经典的疝环充填式无张力疝修补方法与Lichtenstein的修补方法结合起来，将成型补片缝合固定到耻骨结节的腱膜上。
목적료해산배충전식무장력산수보술후망새여성형보편적형태，탐토개진수술방법적필요성。방법응용B초대16례산배충전식무장력산수보술후병인망새화성형보편진행관찰병복습병력，평고수술방법대망새화성형보편형태적영향급수보효과。결과 16례중유4례성형보편하단여치골연중첩，12례미체도치골연。대미체도치골연적12례개변탐두절입각도，발현8례성형보편하단정고밀도구증관영，제시유절첩혹권곡，차고밀도영여치골간환출현일저밀도조직영간극。미체도치골연적12례중11례재수술중몰유장성형보편하단여치골결절고정혹증전단성형보편。결론시행산배충전식무장력산수보술시，성형보편적처리응시술중정황파경전적산배충전식무장력산수보방법여Lichtenstein적수보방법결합기래，장성형보편봉합고정도치골결절적건막상。
Objective Investigate the shape of plug mesh and patch after plug-mesh hernia repair and discuss the necessity of improving the operative procedures. Methods Use B ultrasound to investigate the shape of plug-mesh and patch after mesh plug hernia repair and review the patients medical record,evaluate how operative procedures affect the shape of patch and the results. Results In 4 of the 16 cases,the distant end of patches overlapped the pubic margin,in the remaining 12cases the distant end of patches didn't reach the pubic margin. When changing the cut-in direction of B ultrasound probe,a wide and dense shadow was discovered in 8 cases whose patches didn't reach the pubic margin. Between the pubic margin and dense shadow there was a space showing low dense shadow. These photocopies showed that the patches had folded up or crimped. In 11 of 12 cases,the patches didn't fix on pubic margin or cut shorter during operation. Conclusion It is suggested to fix the distant end of patch on the aponeurosis tissue of pubic in the procedure of mesh plug hernia repair,and combine the plug-mesh repair with Lichtenstein repair.