利希滕斯坦疝修补术后睾丸灌注变化研究

Hansraj Ranga, Vinit Mishra, Vidit Vidit, Mahavir Griwan, B. Arora
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摘要

背景:腹股沟疝气对男性和女性都有影响,但男性更为常见,他们占手术患者的 90% 以上。考虑到手术和非手术治疗的腹股沟疝,75 岁(含 75 岁)以下男性的终生患病率为 47%。修复腹股沟疝是当今西方成人中最常见的手术之一。目的和目标:比较利希滕斯坦疝修补术后睾丸灌注的变化:研究对象包括本院收治的 30 名腹股沟疝患者,研究时间为 12 个月。对所有病例进行了睾丸血流彩色多普勒超声评估。组间结果比较采用独立 t 检验和皮尔逊相关检验:研究中患者的平均年龄为(46.10±17.27)岁。23%的患者合并有慢性阻塞性肺病。术前、24 小时、1 周和 3 个月时睾丸动脉的平均收缩峰值(PSV)分别为(18.36±2.21)、(20.27±3.25)、(19.21±2.31)和(18.98±2.06),P=0.001。进一步观察发现,囊动脉和睾丸内动脉的 PSV 以及睾丸、囊动脉和睾丸内动脉的 EDV 和 RI 无明显差异:精索动脉和睾丸动脉及其分支的血流阻力较低,收缩期血流较宽,舒张期血流较全。没有证据表明,使用无张力技术进行开放式疝修补术后,脊髓结构会受到明显损伤。很明显,精细的手术剥离
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Study of alteration in testicular perfusion after Lichtenstein hernia repair
Background: Inguinal hernia affects both men and women but is much more common in men who comprise over 90% of the operated patients. Considering both the operated and the non-operated inguinal hernias, the lifetime prevalence rate is 47% for men upto and including the age of 75. Repair of an inguinal hernia is one of the most common operations among adults in the western world today. Aims and objectives were to compare the alteration in testicular perfusion following Lichtenstein hernia repair. Methods: Thirty patients diagnosed with inguinal hernia admitted in our hospital with study period of 12 months were included in the study. Color Doppler ultrasound evaluation of testicular blood flow was done for all cases. Comparisons of results between groups were done using independent t test and Pearson correlation test. Results: The mean age of patients in the study was 46.10±17.27 years. Twenty three percent of patients had COPD as comorbidity. Mean peak systolic volume (PSV) of testicular artery in preop, at 24 hours, 1 week and 3 months are 18.36±2.21, 20.27±3.25, 19.21±2.31 and 18.98±2.06 respectively with a p=0.001. On further observations, no significant difference was found in the PSV of Capsular and intratesticular artery and EDV and RI of testicular, capsular and intratesticular artery. Conclusions: Testicular perfusion following hernioplasty can be easily monitored and evaluated with Duplex ultrasonography; the flow in the spermatic artery and testicular artery and its branches is of low resistance, with a relatively broad systolic part and holodiastolic flow. There is no evidence for a significant impairment of cord structures after open hernia repair using tension free techniques. It is clear that fine surgical dissection
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