中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (4): 399-403.

• 应用解剖 • 上一篇    下一篇

脐中襞和脐内侧襞形态特点及其在腹腔镜疝修补术中的意义

刘嘉林,  毕建钢, 田恒宇, 陈 阳, 鲍世韵   

  1. 暨南大学第二临床医学院(深圳市人民医院)肝胆外科,   广东   深圳    518020
  • 收稿日期:2010-11-17 发布日期:2011-07-26
  • 作者简介:刘嘉林(1969-),男,江西九江人,医学博士,主任医师,研究方向:普通外科、微创外科学, Tel:(0755)-25533000-2564

Anatomy of median and medial umbilical ligaments and its significance for laparoscopic herniorrhaphy

LIU Jia-lin, BI Jian-gang,TIAN Heng-yu,CHEN Yang, BAO Shi-yun   

  1. Department of Hepatobiliary Surgery, the Second Affiliated Hospital, Jinan University, Shenzhen 518020,China
  • Received:2010-11-17 Published:2011-07-26

摘要:

目的 应用腹腔镜技术研究国人脐中襞及脐内侧襞与脐环会合的类型,并测量分析脐中/内侧襞宽度分布规律。  方法 自2006 年1 月~2009年12月, 收集了腹腔镜腹股沟疝修补术中463例患者脐正中/内侧襞与脐部会合类型,测量了脐正中襞和脐内侧襞于盆壁附着处宽度,对比分析不同年龄组和男女两性之间脐内侧襞宽度。  结果 脐正中襞和脐内侧襞与脐部会合方式分4型,双侧脐内侧襞与脐正中襞分别独立会入脐环为Ⅰ型22.2%(103例),脐正中襞与一侧脐内侧襞回合后再与另一侧脐内侧襞分别汇入脐环为Ⅱ型43.6%(202例),双侧脐内侧襞与脐正中襞三者会合一起后再汇入脐环为Ⅲ型20.7%(96例),未见脐中襞者为Ⅳ型13.5%(62例),与国外报道相似。在儿童组、青少年组、中青年组和老年组之间,脐正中襞宽度没有差别,但老年组脐内侧襞宽度大于2.0cm以上比例(46.6%)显著低于儿童组(73.9%)。男女两性别之间,脐正中襞宽度也没有差别,但男性脐内侧襞宽度大于2.0cm以上比例(61.6%)显著高于女性(41.4%)。  结论 腹腔镜下国人脐正中襞及脐内侧襞与脐部会合方式可分4型,脐内侧襞宽度在不同年龄、性别之间有显著差异,为腹腔镜腹股沟疝修补术中切取自身材料提供参考。

关键词: 脐中襞, 脐内侧襞, 腹腔镜腹股沟疝修补术, 应用解剖学

Abstract:

Objective To explore the morphologic features of the umbilical ring (MU), the median umbilical ligament (MnU) and the medial umbilical ligament (MdU) under laparoscope. Methods 463 patients undergone laparoscopic herniorrhaphy from 2006 to 2009 were collected. The various shapes of MnU and MdU terminated by MU were identified, and followed by the measurement and comparison of the width of MnU and MdU arising from the pelvis. Results Four types of umbilical ligaments could be identified as the follows: type I (22.2%, 103 cases), with independent convergence of MnU and MdU to MU; type II (43.6%, 202 cases), with the convergence of MnU and unilateral MdU before reaching MU which receiving another MdU independently; type III (20.7%, 96 cases), bilateral MdUs and MnU converged together before their reaching to MU; and type Ⅳ (13.5%, 6 cases), with no MnU. There was no age and sex difference of the width of MnU, however, the percentage of older aged patients with the MdU width of 2.0cm (46.6%) was lower than that of children patients (73.9%), and the percentage of male patients with the MdU width of 2.0cm (61.6%) was higher than that of female patients(41.4%). Conclusions Under the laparoscope, 4 convergence types of MnU and MdU can be identified. There are age and sex difference of the width of MdU, which is notable during the process of laparoscopic herniorrhaphy.

Key words: Median umbilical ligament, Medial umbilical ligament, Laparoscopic herniorrhaphy, Applied anatomy;

中图分类号: