Mr. Wang is more than 60 years old and goes to the park to exercise every day. The regular life makes him look like he is in his 50s. My friends kindly call him the "guy".But recently, the "guy" is a bit wrong: the boxing action can’t keep up, and he always goes home early.Under the care of the boxers, Mr. Wang revealed the truth: Recently, he found that a lump appeared on his small belly. When he didn’t move, it would not hurt and itch, and his stomach would be painful.This lump is still small, and he is worried that he has given birth to any tumors.
Mr. Wang came to the hospital’s abdominal wall hernia surgery clinic. Based on his description, symptoms, and signs, the doctor diagnosed the diagnosis of oblique hernia in the right groin.This actually refers to an extraordinarium of the abdominal hernia that occurs in the groin area, a common old -age surgical disease.
Adding aging, the incidence of groin hernias is getting higher and higher
Modern anatomy research shows that the deep weakness of the stroke area is the defect in the process of human evolution and the fundamental reason for the occurrence of groin hernias. This deep weak area is described as "muscle pubic pores" by physician FRUCHARD in France.The muscle pubic hole is an ovate -shaped cracks located in the anterior abdomen and the pelvis.Its composition is: the upper boundary is the bow -shaped lower edge of the abdominal oblique muscles and abdominal muscles.
The organs or tissues in the abdominal cavity (often the intestinal tube or large omentum), which is raised to the body surface through the weak area (muscle perchow) of the groin on the upper groin of the human abdominal wall, forming a mass, that is, the mass on the belly.
With the age of age, the resistance of the elderly body gradually decreases, and the abdominal muscles lack corresponding exercise to continuously degenerate or even shrink. In addition, there are often chronic constipation and prostate hyperplasia such as increasing abdominal pressure. The incidence of groin hernia is getting higher and higher.A survey of an epidemiological disease in my country shows that the prevalence of homic hernias over 60 years of age reached 1.13%.With the aging of population aging and rough budgets, China will increase about 2.7 million patients with groin hernia each year, which seriously affects the quality of life of the elderly.
Not tumor, diverse classification and performance
Is this lump tumor?Why is Mr. Wang’s "oblique hernia", is it meaningful?In terms of Mr. Wang’s case, his mass is because the small intestine in the belly drill into the hernia sac formed by the underpirin tissue of the skin, and it is bulging like a balloon, so the folk is also called "small intestine qi". This is not this notTumor.Candid hernia is one of the inguinal hernias. There are roughly several categories of groin hernia:
First, the anatomical site (most commonly used in clinical) in the hernia: 1. Candid hernia: from the inner ring into the hernia of the groin tube.2. Straight hernia: Herbs of protruding from straight hernia triangle.3. Herbon: Enter the hernia of the femoral pipe through the stock ring.4. Compound hernia: At the same time, there are two or more hernias.5. Herbs around the femoral blood vessels: hernias can be located in front of the femoral blood vessels.
Second, the status of the hernia sac by the hernia content is divided into: 1. Easy to relax hernia: The hernia often occurs during the patient stands or moves.2. Ferry reproduction of hernia: The hernia cannot be fully returned, but the content of the hernia content has not changed.Sliding hernia is a type of difficulty, and some hernia sacs are composed of abdominal viscera (such as cecum, bladder, etc.).3. Anchidal hernia: The content of the hernia is pressured at the hernia ring. It cannot be repaid. It may be accompanied by clinical symptoms (such as pain and digestive tract obstruction), but the content of the hernia has not yet occurred.4. Pinged narrow hernia: The continuation of the inlapping hernia course, the content of the hernia content has a bloody disorder. If it is not treated in time, it can occur in severe complications.
Third, a special type of hernia.1. Some intestinal wall incarceration hernia (Richter hernia): The content of the incarceration is only part of the intestinal wall.2. Small intestine diverticulum embedded hernia (LITTRE hernia): The content of the embedded hernia is a small intestinal diverticulum.Such hernias are also prone to narrowing.3. Rebellion intestinal 嵌 嵌 3 (MayDL hernia): There are two or more intestinal crickets enter the hernia sac. The intestinal cymbal is located in the abdominal cavity such as "W"., But the intestinal crickets in the abdomen may have necrosis and need to be checked.4. The appendix embedded hernia (AmyAnd hernia): The content of the hernia is the appendix, which can affect the repair due to the often complicated, necrotic and purulent due to the appendix.
Once discovered, treatment as soon as possible
Since it is not a tumor, it doesn’t matter?Do you want to treat it?
Many elderly people think that hernias are not painful and itchy. Although they can touch the block during the day, the lumps disappear when they sleep at night, so they think that there is no need to treat.In fact, hernias are harmful to the human body.For example, patients will experience abdominal bloating, abdominal pain, constipation, which causes poor appetite, poor nutritional absorption function, prone to fatigue, and reduced physical fitness.
In order to avoid the prominent content of the inguinal hernia, many patients will choose to reduce standing, walking, exercise and cough, reduce their physique, and the quality of life is greatly affected.
Due to the adjacent groin area and urogenital system, the inguinal hernia is likely to aggravate the symptoms of the bladder or prostate disease, causing frequent urination, urgency, and increasing luminuria in elderly patients.Progressive hernia content may affect the normal development of children and the fertility function of adults.
In addition, the intestinal tubes or omites in the inguinal hernia have been prominently for a long time, which is easy to squeeze or collide, causing inflammation and edema of hernia sac cervices, resulting in difficulty in the content of the content.Intestinal perforation, infectious shock and even death.
The inguinal hernia not only gives patients physiological inconvenience, but also reduces social activities in patients due to long -term physiological inconvenience, but also psychologically cause depression and inferiority, which leads to distorted and division of patients.Therefore, it is recommended to treat as soon as possible if the inguinal hernia is found.
Most people are afraid of surgery. I hope to solve the inguinal hernia through conservative treatments such as injections and medicine.Complications, thus life -threatening.
Every year, patients with more than 20 million groin hernias worldwide are treated with surgery. At present, the mainstream inguinal hernia surgery is not only traditional open hernia repair, but also laparoscopic hernia repair surgery, each with its own characteristics.
Laparoscopic surgery: The trauma of the body surface is small, the recovery is fast, and the incision is more beautiful, but a set of laparoscopic equipment is required, so the cost of surgery is higher than the operation.Qi belly has certain restrictions on patients with poor patients with poor cardiopulmonary function.
Open -type no tension and replenishment surgery: Only half -body anesthesia is required to perform surgery under local anesthesia without special anesthesia without special laparoscopy equipment. The price is relatively cheap.
The recurrence rate of both types of surgery is very low, about three -tenths; more, the earlier the surgery, the better the surgery effect, which can ensure the health and quality of life of patients to the greatest extent.
(The author is Mu Jiasheng, a general surgeon at Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine)
Source: Wen report