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小儿腹股沟疝修补术 - 男性

ID: ANH13086chis
医学动画文字记录:腹股沟疝通常表现为下腹部(也称为腹股沟或阴囊)隆起。出生前,男性胎儿的睾丸在腹腔内生长,然后下降到阴囊。睾丸下降到阴囊,必须通过腹股沟环内环和外环这两个开口,以及它们之间的通道,即腹壁肌肉形成的腹股沟管。当睾丸进入阴囊时,腹壁上的组织随之形成一个囊。通常情况下,囊进入腹股沟管的开口会在出生后6个月内关闭。有时由于不明原因,囊的开口没有关闭,结果导致开放的组织囊可能充满了通常情况下留在腹部的液体。睾丸周围的囊充满的液体称为鞘膜积液。婴儿肠道的一小部分或腹部的一些脂肪组织也可能滑入囊中,导致腹股沟疝。通常,医生能够轻轻地将肠道推回腹部。然而,肠道也可能嵌顿在组织囊内,表现为一个坚硬而易痛的凸起,这是一种紧急情况。大约6个小时后,嵌顿疝内的肠道可能会失去血液供应而坏死。此时称为绞窄性疝,是一种紧急情况,需要立即就医和手术来修复。鞘膜积液和腹股沟疝需要进行手术以结扎并去除组织囊,以预防疝的发生和可能对小肠造成的伤害。首先,外科医生将在疝附近做一个小切口。接下来,将小心地将组织囊与索状结构分开,包括小血管和附着在睾丸上的输精管。然后,医生将打开囊以寻找里面是否有任何突出的内容物。通常,囊是空的。但是,如果存在突出的内容物,要将它们移回腹部。有时对于2岁以下的儿童,医生会通过开放的组织囊插入腹腔镜。腹腔镜有一个摄像头,外科医生通过它可以查看另一侧的内环,判断另一侧是否有疝。如果另一个内环是开放的并且有疝,将需要在该侧进行类似的修复。在检查另一侧是否有疝之后,医生将用缝线将空组织囊结扎起来。囊的其余部分将被切除。最后,使用可溶解缝合线、皮肤粘合剂或闭合胶带敷料关闭切口。婴儿可能会在切口附近的皮肤上注射麻醉剂,以帮助控制手术后疼痛。要了解有关修复小儿腹股沟疝的更多信息,请咨询医生。

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