腹股沟疝 ppt课件

《腹股沟疝 ppt课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、腹股沟疝涿州市医院普外肝胆外科刘增亮www.themegallery.comCompanyLogowww.themegallery.comCompanyLogo托雷斯德鲁—古登www.themegallery.comCompanyLogo公牛队大前锋德鲁-古登(DrewGooden)www.themegallery.comCompanyLogo查尔斯王子www.themegallery.comCompanyLogo麦当娜www.themegallery.comCompanyLogo李敖www.themegallery.comCompanyLogo朱

2、仲丽内容目的了解--腹外疝种类、类型、病因掌握--腹股沟疝的诊断和治疔方法熟悉--腹股沟疝的鉴别诊断腹外疝的概念腹外疝(AbdominalHernia)腹腔内的脏器经腹壁缺损处向体表突出形成的皮下包块，称为腹外疝。www.themegallery.comCompanyLogo病理解剖疝囊疝内容物疝外被盖www.themegallery.comCompanyLogo疝囊解剖部位命名囊颈囊体囊底www.themegallery.comCompanyLogo前腹壁疝的位置及名称www.themegallery.comCompanyLogo腹股沟疝ingu

3、inalhernia定义：腹腔内脏器在腹股沟处通过腹壁缺损突出者，称为腹股沟疝。最常见占腹外疝的90%。www.themegallery.comCompanyLogo腹股沟斜疝疝囊经过腹壁下动脉外侧的腹股沟管深环（内环）突出，向内、向下、向前斜行经过腹股沟管，再穿出腹股沟管浅环（皮下环），并可进入阴囊。斜疝www.themegallery.comCompanyLogo腹股沟直疝直疝从腹壁下动脉内侧的直疝三角由后向前突出,不经过内环,一般不进入阴囊直疝www.themegallery.comCompanyLogo腹股沟区解剖概要腹股沟区的解剖层次(由

4、浅而深):(1)皮肤,皮下组织,浅筋膜(2)腹外斜肌及腹外斜肌腱膜:腔隙韧带(陷窝韧带)耻骨梳韧带(3)腹内斜肌和腹横肌:联合肌腱(4)腹横筋膜:腹股沟内环(深环,腹环)凹间韧带(5)腹膜外脂肪和壁层腹膜www.themegallery.comCompanyLogo腹股沟区解剖www.themegallery.comCompanyLogo腹股沟区解剖www.themegallery.comCompanyLogo腹股沟区解剖www.themegallery.comCompanyLogo腹股沟管解剖成年人长4-5cm,两口四壁直疝三角三边www.the

5、megallery.comCompanyLogo腹股沟管解剖腹股沟外侧三角直疝三角股三角腹股沟韧带耻骨腹壁下动脉斜疝直疝耻骨肌孔腹直肌外侧缘www.themegallery.comCompanyLogo腹股沟疝发生原因Whydoesinguinalherniahappen？原因www.themegallery.comCompanyLogo现代医学的观点腹壁薄弱腹压增高www.themegallery.comCompanyLogo腹股沟疝分先天性和后天性(1)先天性斜疝:未闭的鞘突成为疝囊右侧睾丸下降略晚,故右侧腹股沟疝多见(2)后天性斜疝:与腹股沟

6、区解剖缺损有关与腹横肌和腹内斜肌发育不全有关腹股沟直疝:与腹内斜肌弓状下缘发育不全或位置偏高有关www.themegallery.comCompanyLogo腹内压增高慢性咳嗽慢性便秘排尿困难腹水妊娠举重婴儿啼哭www.themegallery.comCompanyLogo临床表现和诊断1.主要临床表现:腹股沟区可复性肿块2.其他临床表现:www.themegallery.comCompanyLogo临床表现和诊断易复性疝难复性疝嵌顿性疝绞窄性疝表现类型www.themegallery.comCompanyLogo鉴别诊断睾丸鞘膜积液交通性鞘膜积液

7、精索鞘膜积液隐睾急性肠梗阻www.themegallery.comCompanyLogo鉴别诊断www.themegallery.comCompanyLogo？？讨论www.themegallery.comCompanyLogo斜疝直疝讨论www.themegallery.comCompanyLogo治疗非手术手术治疗www.themegallery.comCompanyLogo中世纪血与火按麻烙铁沸油止血切除疝囊睾丸www.themegallery.comCompanyLogo非手术疝带www.themegallery.comCompanyLog

8、o硬化剂Xwww.themegallery.comCompanyLogo手术传统的疝修补术无张力疝修补术经腹腔镜疝修补术w