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中华疝和腹壁外科杂志(电子版) ›› 2018, Vol. 12 ›› Issue (04) : 259 -263. doi: 10.3877/cma.j.issn.1674-392X.2018.04.007

所属专题: 文献

综述

运动型疝的诊治
蔡轩1, 柏楠1,(), 毕敬涛1   
  1. 1. 100035 北京积水潭医院普外科
  • 收稿日期:2018-03-14 出版日期:2018-08-18
  • 通信作者: 柏楠

Development of diagnosis and therapeutics of Sports hernia

Xuan Cai1, Nan Bai1,(), Jingtao Bi1   

  1. 1. Department of General Surgery, Beijing Jishuitan Hospital Huilongguan District, Beijing 100035, China
  • Received:2018-03-14 Published:2018-08-18
  • Corresponding author: Nan Bai
  • About author:
    Corresponding author: Bai Nan, Email:
引用本文:

蔡轩, 柏楠, 毕敬涛. 运动型疝的诊治[J/OL]. 中华疝和腹壁外科杂志(电子版), 2018, 12(04): 259-263.

Xuan Cai, Nan Bai, Jingtao Bi. Development of diagnosis and therapeutics of Sports hernia[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2018, 12(04): 259-263.

运动型疝常见于运动员群体,与其症状相近的鉴别诊断较多,故需要经过仔细的询问病史和客观查体及辅助检查才能做出诊断,核磁共振是最重要的辅助检查手段。在治疗方面,保守治疗已成为首选方案,特别是物理康复治疗。传统开放入路和腹腔镜经腹腹膜前疝修补术、腹腔镜完全腹膜外疝修补术等手术治疗均安全有效,但各种术式的选择仍缺乏高级别临床证据指导。目前对于运动型疝的研究仍然在摸索阶段,其诊断和治疗尚未达成统一共识,仍需要大量的前瞻性临床试验研究提供依据。

To summarize the development of diagnosis and therapeutics of Sports hernia. The literature relating to sports hernia in recent years has been reviewed and compared. The term 'inguinal disruption’ (ID) was agreed as the preferred nomenclature with the term 'Sports hernia’ rejected, as no true hernia exists. MRI is probably the most important and effective method for sports hernia. And rehabilitation is playing a big role in treatment. Although, clinical practices have proved that open surgery and laparoscopic surgery are all safe and reliable for sports hernia, there is insufficient scientific evidence to strongly recommend one practice over another. Up to now, researching in sports hernia is still on its exploring period. We have not reached consensus on its diagnosis and therapeutics. More researches with high grade evidence are needed in the future. There is much work to do.

图1 1A中白色粗箭头处为腹直肌和长收肌,箭头方向为两肌肉运动的矢量方向;右侧白色细箭头为两肌肉在耻骨结节处的附着点,并在耻骨结节前方相互延续成一层筋膜组织;左侧白色细箭头处为腹股沟管外环,其紧邻上述结构。2B在MRI矢状位上展示腹直肌、长收肌和耻骨结节的位置关系[19]
图2 2A为24岁男性足球运动员,在轴位T2像左侧耻骨前方高信号显示骨髓肿胀[18]。2B为职业足球运动员,在MRI冠斜位T2像高信号处提示耻骨前撕裂性损伤,同时波及整个右侧腹直肌-长收肌腱膜(白色细箭头)和左侧部分腹直肌-长收肌腱膜(白色箭头),还有右侧耻骨肌和长收肌的水肿(白色弧形箭头处);2C在MRI轴位白色箭头处示局多处的撕裂伤致血肿蔓延至腹股沟管内;2D在MRI矢状位白色细箭头处T2高信号提示腹直肌-长收肌间腱膜撕裂[8]
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