腹股沟直疝和腹股沟斜疝有什么临床区别,该如何处理?非小孩

2025年04月07日 12:50
有2个网友回答
网友(1):

疝由疝环、疝囊、疝内容物和疝外被盖组成。腹股沟疝有斜疝和直疝二类。1.腹股沟斜疝发病机制是腹内脏器或组织经腹股沟管突出形成,占腹外疝的90%,男性多见。斜疝的发生有先天性和后天性两种因素。先天性斜疝是发育过程中开始睾丸位于腹膜后,随腹膜形成的鞘突下移,经腹股沟管至阴囊,鞘突下段成为睾丸固有鞘膜,其余部分萎缩闭锁成纤维索带。患儿如腹内压增高、过频、过强,鞘突不能闭锁,即成为先天性斜疝之疝囊,构成斜疝或鞘膜积液,或同时存在。后天性斜疝的发生是:(1)腹股沟区解剖缺陷,腹壁薄弱;(2)腹横筋膜和腹横肌发育不全,不能关闭腹股沟管深环;(3)腹内压增高。往往是共同作用所致。2.斜疝临床病理类型有易复性、难复性、嵌顿性、绞窄性疝4种类型:(1)易复性疝:是指疝内容物突入疝囊后,经平卧或用手推送,疝内容物易回纳入腹腔。(2)难复性疝:是疝内容物反复突出,致疝囊颈受摩擦产生粘连,使疝内容物不能完全回纳入腹腔。这种疝的内容物大多为大网膜。此外巨大疝也常难以回纳。如深环较宽大、后腹壁松驰,致盲肠、乙状结肠、膀胱下移,滑入疝囊并成为疝囊的一部分,这种疝称滑动性疝,常不能完全回纳,亦属难复性疝。(3)嵌顿性疝:在疝环狭小而腹压突然增高时,疝内容物可强行扩张疝环和疝囊颈而进入疝囊,由于疝环弹性收缩,将疝内容物卡住不能回纳,即形成嵌顿性疝。疝内容物如为肠管,受压水肿,可形成肠梗阻。如不发生血循环障碍,嵌顿解除,可恢复正常。应注意在疝环处肠管易压迫坏死。(4)绞窄性疝:疝内容物被嵌顿时间过久,发生动脉性血循环障碍,失去活力,甚至坏死,即为绞窄性疝。整段肠管嵌顿、绞窄形成机械性肠梗阻。如为部分肠管壁被嵌顿,未发生完全性肠梗阻称肠管壁疝;如小肠憩室被嵌顿则为李特疝。儿童疝环组织柔软,嵌顿后很少发生绞窄。.

网友(2):

腹股沟直疝和腹股沟斜疝的临床区别主要有以下几个方面:1、年龄:直疝多发于老年人,斜疝多方与小儿几青少年;2、是否进入阴囊或大阴唇,直疝不进入,斜疝严重时可进入。

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